Padma Shree Awardee, Author of book “Diabetes with Delight”.
A fully compliant patient came to my clinic recently in a very disturbed mood. His fasting blood sugar was ~300 mg/dl (markedly uncontrolled). He said in an emotional tone; “Doc. Such high sugars never happened before Covid-19, and I just had a mild disease”.
This is an oft-repeated first scenario these days. A second scenario is new-onset diabetes during COVID-19 infection in previously non-diabetic people. This may happen most often after severe COVID-19 but may also occur with mild disease. A third scenario is people with post-Covid-19 syndrome (“Long COVID”) who have high sugar values. Finally, those with diabetes, or even prediabetes, are likely to get severe COVID-19.
The factors that work against the pancreas (that controls blood sugar) are severe attacks of Covid-19 on this organ, poisonous substances generated by COVID19 (“Cytokine storm”), marked mental stress, and use of steroids, to name a few. It appears that COVID-19 uncovers a huge tendency of Indians for diabetes. Overall, we are seeing more patients with uncontrolled sugar now than ever before, and these patients show various complications of diabetes.
In the current era, many patients are suffering from post-COVID-19 Syndrome where fatigue, headache, muscle pains, muscle pains, lack of concentration, memory loss, singly or in combination may occur. This syndrome can be extremely debilitating and may take several months to resolve. In such a situation, stress and poor body physiology could lead to rise in blood sugar values. Patients with uncontrolled diabetes suffer from prolonged and severe fatigue after COVID-19, our recent research shows. In such patients, withering of muscles is prominently seen, and carrying out daily activities appears to be a major burden.
Who are people most prone to develop diabetes during this era (or for that matter any era)? Those who are obese, have poor fitness and lifestyle, have strong family history of diabetes, and those having hypertension, cholesterol disorders and heart disease. Women are particularly susceptible if they history of high sugar during pregnancy or are post-menopausal, obese, and sedentary.
Be vigilant and get yourself checked up for blood sugar (and blood pressure) at the earliest opportunity if you belong to previously mentioned categories. Keep a disciplined lifestyle with daily physical exercise. A few patients told me that they could not follow exercise because of COVID-19 related restrictions, and this led to high blood sugar in them. I tell them a story about an overweight patient, who was confined to only one room during the pandemic, yet he managed to lose weight by doing on the spot and resistance exercises in good measure since he has “too much time”.
Always be in conversation with your physician for advice. Those who have diabetes must continue taking drugs and when blood sugar goes up, escalate drugs as per advice. In post covid syndrome, maintenance of nutrition (vitamins like B12 and D, and good protein diets) is particularly important. Sometimes nutritional supplements are required especially in elderly. Gradual physical rehabilitation with graded physical activities helps. Gain of strength of muscles is faster when blood sugar and blood pressure are under control. Above all, keep the mind engaged in a positive manner, and any type of meditation may assuage disturbed body physiology.