Managing your blood sugars may reduce your risk of these life-threatening issues.
While researchers continue to learn more and more about COVID-19, it’s already obvious that complications of COVID-19 can be life-threatening. These complications occur when organs falter—or in some cases, overreact—in response to the effects of the coronavirus in their body.
Anyone can experience these complications, but some groups of people are more at risk than others. This includes people with diabetes.
“People with diabetes should be particularly cautious about contracting COVID-19 because they can experience more severe complications if they do, in fact, get infected,” says Minisha Sood, MD, endocrinologist. Learn more here about how COVID-19 affects people with diabetes differently.
What Are the Complications?
There’s a wide range of potential complications, but some are more common than others. “Some of the most common complications from COVID-19 that people with diabetes are experiencing include pneumonia, respiratory failure, and septic shock,” says Dr. Sood.
Pneumonia is inflammation in the lung tissue which can be due to bacterial, fungal, or viral infections, such as COVID-19 or influenza. Says Dr. Sood, “That inflammation can lead to fluid buildup and an immune response that makes oxygenation of the blood difficult.”
Respiratory failure refers to when the blood isn’t getting enough oxygen. This can occur because COVID-19 can affect breathing and inhibit oxygen intake.
Septic shock is an overreaction of the immune system. It involves dangerously low blood pressure and dehydration caused by a body-wide infection.
Additionally, COVID-19 can affect the cardiovascular system. It may cause cardiac issues like heart failure, and it increases the risk of blood clots.
COVID-19 and Ketoacidosis
People with diabetes in particular need to be aware of the risk of ketoacidosis. Having a viral illness—such as COVID-19—increases the risk of this diabetes complication.
“The viral illness is a stress on the body, and under that stress blood glucose levels will rise,” says Dr. Sood. “In addition, the virus itself can impair the body's ability to make insulin.” Insulin helps your body use blood sugar. Thus, when you’re low on insulin, your body thinks it can’t use the available blood glucose for fuel—despite the rising glucose levels.
“Under those conditions the body makes ketones or acids as an alternative fuel. If the acids or ketones build up in the body this can lead to dehydration, which can be profound,” says Dr. Sood. Other symptoms of diabetic ketoacidosis include confusion, nausea, and vomiting.
How to Protect Yourself
If you have diabetes, you may feel vulnerable and worried about your health during the COVID-19 pandemic.
“My advice to patients with diabetes [is] to feel empowered and to take this opportunity, as difficult as it is, to control their blood glucose better, to open channels of communication with their healthcare providers, to test their blood sugars more often, maybe even to work on treating overweight, obesity, high blood pressure, high cholesterol,” says Dr. Sood.
It's also important to be cautious to prevent COVID-19 infection altogether. Here are tips for at-risk groups to prevent COVID-19.
Dr. Sood is a board-certified endocrinologist in private practice in New York City and an assistant professor at Hofstra School of Medicine.
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People with diabetes are more likely
to have serious complications
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from COVID-19 for several reasons.
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First of all, high blood glucose or high blood sugar
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impairs the immune system's ability to fight off infections.
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Also, there's an increased environment
of chronic inflammation,
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which affects the immune system,
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in that it's more likely to trigger a cytokine storm
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or an overreaction of the immune system,
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which could lead to complications down the line.
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Chronic inflammation also creates an environment
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in the blood vessels,
whereby blood clots
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are more likely to form.
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Some of the most common complications from COVID-19
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that people with diabetes are experiencing
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include pneumonia, respiratory failure, and septic shock.
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Pneumonia is infection and inflammation
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due to viral illnesses in the lung tissues,
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and that inflammation can lead to fluid buildup
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and an immune response that makes oxygenation
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of the blood difficult.
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Respiratory failure is a condition where the lungs
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develop a difficulty in delivering oxygen to the blood.
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Septic shock develops in patients with COVID-19
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due to a body-wide infection from the virus
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that causes COVID-19.
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Septic shock signs include very low blood pressure,
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dehydration, perhaps even some confusion,
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COVID-19 infection increases the risk
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of diabetic ketoacidosis.
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This occurs because the viral illness
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is a stress on the body, and under that stress,
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blood glucose levels will rise,
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which is the body's natural response to infection.
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In addition, the virus itself can impair
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the body's ability to make insulin.
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If there's no insulin around, or not enough insulin around,
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then the body perceives that it can't use
that blood glucose
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or blood sugar as fuel,
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even though blood glucose levels are high.
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Under those conditions, the body makes ketones,
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or acids, as an alternative fuel.
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If the acids or ketones build up in the body,
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this can lead to dehydration, which can be profound,
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sometimes even confusion, nausea, vomiting,
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and electrolyte problems,
and medical attention is imperative.
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Patients with diabetes who are worried about
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how the COVID-19 pandemic might affect them
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would hopefully feel not defeated but empowered
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to take this opportunity to dial in
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and better control their conditions.
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This could include having more conversations
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with their healthcare providers,
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beginning blood glucose testing
if they're not testing already,
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understanding what better blood glucose levels mean,
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also controlling other conditions that often go along
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with diabetes, including overweight, obesity,
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high blood pressure, and high cholesterol.
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All of these measures can actually lower one's risk
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for severe complications from COVID-19.
- Coronavirus disease 2019 (COVID-19): critical care and airway management issues. Waltham, MA: UpToDate, 2020. (Accessed on July 29, 2020)
- How COVID-19 impacts people with diabetes. Arlington, VA: American Diabetes Association. (Accessed on July 29, 2020)
- People with certain medical conditions. Atlanta, GA: Centers for Disease Control and Prevention, 2020. (Accessed on July 29, 2020)
- Respiratory failure. Washington, DC: MedlinePlus, U.S. National Library of Medicine. (Accessed on July 29, 2020)
- Septic shock. Washington, DC: MedlinePlus, U.S. National Library of Medicine. (Accessed on July 29, 2020)
- What is known about COVID-19 and abnormal blood clotting. New York, NY: Weill Cornell Medicine, 2020. (Accessed on July 29, 2020)