CHENNAI: One month after recovering from COVID-19, 32-year-old S a n - geetha N vi s i t e d Wootu Nutrition to work on the weight she had gained in the past year. Imagine her shock when she received a pre-diabetic diagnosis, despite having no history of high blood sugar. While she had some family history of diabetes, she had shown no symptoms pre-Covid.
This is, however, not an isolated case. In May, The Journal of Diabetes, Obesity and Metabolism published a report claiming that 14.4 per cent of hospitalised COVID-19 patients returned home with diabetes and ever since, there have been more studies focussed on updated statistics. While Sangeetha was never hospitalised, this result had caught her off guard. “My earlier tests never read over 100 mg/dL. I could never have imagined that I would be diagnosed with borderline diabetes at that checkup,” she says.
While this may seem strange and sudden, there are quite a few reasons for the increasing presence of post-COVID diabetes, according to Dr Ashwin Karuppan, internal medicine and diabetologist consultant at Gleneagles Global Health City. “We observe that patients of COVID-19 have a wide fluctuation of blood sugar, possibly because of the stress levels of the body and the insulin separation that occurs during the infection. Many patients have acute infections that aggravate their blood sugar, which, in turn, provokes the COVID-19 infection. Like any acute infection, it increases the body’s resistance to insulin,” he says.
Furthermore, suppression of beta cells is also observed during COVID-19, which means during a cytokine storm, those who were borderline are found to be permanently diabetic. A cytokine storm refers to when a body releases too many cytokines (small proteins) into the blood rapidly. Another suspicion is a negative effect of COVID on the pancreas that accelerates the process for those susceptible to diabetes.
Unfortunately for Sangeetha, her family history of diabetes made her more prone to this condition. However, those who are hale and hearty are not entirely shielded from it either. Vijaya Kumari, at the age of 65, led a healthy lifestyle and had no affected family apart from her sisters who had been diagnosed in their early sixties. She seemed to have made it out of the danger zone when she contracted COVID-19 in January 2021. Upon hospitalisation, she presented with high blood sugar and was given doses of insulin regularly. It was at her twomonth check-up that she had been diagnosed with a risk of diabetes. “Before COVID-19, everything was completely normal. I had no blood pressure or high sugar,” she comments.
While some people do display high blood sugar post-COVID, it is the lifestyle, diet, exercise and consults that follow in the coming weeks that determine the chances of recovery. Patients tend to make common mistakes (discontinuing medication, for one) that can aggravate the issue. Vijaya, however, handled the matter well with her daughter’s expertise. A nutritionist, her daughter planned her diet for her recovery. “By habit, I am not a very heavy eater. I began to cut down on carbohydrates and took more protein. I continued my medicines for a month. After all this, it took nearly eight months for my blood sugar to become normal,” elaborates Vijaya.
Predisposition to diabetes, however, is not only genetic but also a consequence of a poor lifestyle. Smoking, drinking, lack of sleep, unhealthy diet, sedentary living and extreme stress, while already red flags for many a health condition, have only become more of a trigger given our confined-athome condition. Committing to healthy eating habits and some exercise, even for a few minutes a day, is imperative, expert suggests. “Never underestimate the long term complications of COVID. Most patients can develop diabetes and the only way to avoid it is a healthy lifestyle. If you haven’t started repairing your own, this is the time to do it,” concludes Dr Ashwin.
Post-hospitalisation mistakes and what to change, by Dr Ashwin Karuppan: