World Diabetes Day: Almost half of Covid deaths suffered from diabetes in Haryana
On World Diabetes Day, which falls on November 14, data from Haryana’s Covid-19 bulletins are telling -- almost 48% of the 1,900 people who died had diabetes as a co-morbidity factor, and about 1 in 8 of those who died had only diabetes.
Diabetes can be categorised into type-1 (occurs when there is insufficient production of insulin, which controls blood sugar) and type-2 (inefficient processing of insulin). It is considered to be a lifestyle disease that is caused by, among other things, lack of exercise.
“Apart from these people suffering from these two, there are also those who do not yet know that they have the disease. Covid-19 shows severe symptoms in all three ,” said Dr. Atul Luthra, additional director, diabetes and endocrinology, Fortis Hospital, Gurugram. “Several studies done in the last six months to evaluate effects of the Sars-CoV-2 virus (which causes Covid-19) on diabetic patients show that it has an adverse outcome. There is a higher chance of hospitalisation, intensive care requirement and multi-organ failure. Those having uncontrolled diabetes are largely at risk considering the high mortality.”
According to Luthra, although proper medication can help a diabetic Covid-19 patient to recover just like any other patient, they would require higher dose of medicines after treatment to keep complications at bay.
“Despite the rising burden of diabetes, awareness about risk factors, timely disease detection and effective management remains low. Lack of routine check-ups and inadequate understanding of symptoms implies that many people keep living with the undetected disease for years,” said Dr Shankar Narang, COO, Paras Healthcare. “A cross-sectional study conducted jointly by several organizations including the Public Health Foundation of India in 2019 estimated that almost 47% of Indians with diabetes do not know they have the condition. This makes it almost half the total diabetic population. This highly dangerous situation.”
The key factors that increase fatality among Covid-19 patients with diabetes are defects in T-cell immunity, baseline high levels of cytokines and comorbidities such as obesity, coronary heart disease, hypertension and chronic kidney disease, among others.
Dr. Yatin Mehta, chairman, Institute of Critical Care, Medanta Hospital, who has published a paper on Covid-19 causing complications in case of pre-existing diabetes, said that due to coronavirus disease, sugar level can go out of control even in patients having undiagnosed diabetes. “It leads to something we call diabetic ketoacidosis, a severe form of diabetes. Our study found it in a significant number of Covid-19 patients. Therefore, chances of mortality are always higher,” said Mehta. “Covid-19 can also lead to pancreatitis which can possibly make a patient diabetic even if he/she is not diabetic before the infection. It can happen on its own.”
Doctors advice people to maintain a healthy lifestyle, daily exercise and proper medication to keep the disease in check.