The danger lurks: Concerning trend in patients with diabetes during the COVID-19 pandemic
By Vishwanath Pattan, M.D. Sep 28, 2020
My name is Dr. Vishwanath Pattan and I am the Medical Director of Endocrinology at Wyoming Medical Center in Casper. Endocrinology is the study of hormones, and as an endocrinologist I treat patients for a wide variety of diseases related to hormonal deficiencies and imbalances. That includes many patients with diabetes.
At my clinic, Wyoming Endocrine and Diabetes, I treat patients from across Wyoming, and I have noticed an alarming trend for my diabetic patients in relation to the COVID-19 pandemic: an inability to monitor and control glucose or maintain weight in the summer months.
In a typical year, diabetic patients tend to lose weight and achieve better glucose control in the summer because they are able to live a much more active outdoor lifestyle. During the winter, I often see the opposite trend of added weight, less stable glucose levels, seasonal depression, and an increase in overall stress.
2020, however, has not been a typical year, and I have noticed a deviation from the typical summer pattern in my diabetic patients. Many of these patients have actually gained weight, exhibited less than stable glucose control, and had an increase in their overall stress levels.
I have a few theories on why this might be. When COVID-19 was first acknowledged as a public safety concern, people were quick to stock up on everything they could. As we know, the shelf life of heavily processed foods is what makes them some of the first to go amidst a global crisis. These foods are built to stand the test of time, but for a diabetic patient, they can easily contribute to an unsafe fluctuation of glucose. There was also a lot of uncertainty, fear, and confusion that caused millions to be left without a job and the added stress of strict isolation measures. People were forced to live a much more sedentary lifestyle, whether they wanted to or not, and eat food that does not promote a healthy glucose level. I also saw a major decrease in correspondence with many of my patients with uncontrolled diabetes, further contributing to an atypical summer for the diabetic population.
So, why does this raise a red flag?
Although patients with diabetes are not at any further risk of contracting COVID-19, they are much more likely to suffer greater complications because of it. These complications could lead to the need for ventilator support, further intensive care, and even higher death rates by several folds. This leads me to my main concern with so many of my diabetic patients experiencing poor glucose control prior to a season in which it is already difficult to manage: A person with uncontrolled diabetes in the summer is more likely to have uncontrolled diabetes in the winter, especially during a global pandemic. With the dual-threat of COVID-19 and this upcoming flu season, it is paramount that people with diabetes put their health and safety at the forefront.
I strongly urge people with diabetes and their families to safely support one another through the winter months with the helpful information discussed below.
People with diabetes should:
- Monitor glucose regularly, per your healthcare provider’s recommendation
- Make sure to follow-up with your healthcare providers, either in person or by utilizing virtual visits. (Healthcare facilities take utmost care and precautions, and put your health as a top priority, so in-person visits should be safe). In the coming months, it is essential to keep your providers up-to-date on your progress, and you should discuss individualized glucose goals with your doctor
- Contact your healthcare provider immediately if your blood glucose is above target
- Remain compliant with medication regimens and dietary treatment plans
- Aim to eat a balanced diet, exercise regularly and get adequate sleep – at least between 7 and 8 hours per night
- Maintain a healthy immune system by prioritizing glucose control, managing stress levels and taking a Vitamin D supplement. In Wyoming, most people are naturally deficient during the winter months and are encouraged to seek their healthcare provider’s recommendation for proper supplementation
Family members of diabetic patients should:
- Encourage your loved one to keep appointments with healthcare providers
- Assist them with technology for virtual visits
- Avoid social gatherings, practice proper hand hygiene, and always wear a mask in public spaces to keep your loved one safe
- Help with cooking balanced and healthy meals
- Ensure that your loved one has at least 4 to 6 weeks’ worth of diabetic supplies on hand in case of supply issues later on. These include testing strips, insulin, and necessary insulin administration equipment
- Remind patients to take their medication on time and encourage compliance with glucose monitoring
- Help to maintain a stress-free environment at home
Thank you for your time and attention. Making a sustained, diligent effort to manage your diabetes now can help protect your health in the months to come.
Dr. Pattan is board certified in internal medicine. He completed an endocrinology research fellowship at Mayo Clinic and a clinical endocrinology fellowship at Harbor UCLA/City of Hope in California. Dr. Pattan grew up in India, a country with a near pandemic of diabetic patients. He chose endocrinology because he thought he could make a big health impact by helping patients manage and prevent diabetes.