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COVID-19 :
A recent study, published in The Lancet, points this out the coronavirus pandemic has highlighted the vulnerability of people with diabetess, which often lack access to prevention and treatment plans, causing thousands of preventable deaths every day around the world.
Official data indicate this 463 million people suffer from this disease, which mostly affects low- and middle-income countries, which represent 80% of the total, while the number of deaths worldwide reached 4.2 million in 2019.
Diabetes also reduces life expectancy in adults of average age between four and ten years and, at the same time, the risk of death from cardiovascular disease, kidney disease and cancer increases. Also, the virus that causes COVID-19 at least twice the risk of death or serious illness in diabetic patients or in those with complications from diabetes.
Three questions on diabetes and COVID-19
In this sense, the Spanish Diabetes Society (SED) answers a series of fundamental questions related to diabetes and the possibility of contracting COVID-19.
Are people with diabetes more likely to get COVID-19?
People with diabetes are no more likely to get COVID-19 than the general population. The problem that people with diabetes who contract the coronavirus can have is one with worse outcomes, not a greater chance of contracting the virus.
Are people with diabetes more likely to have serious complications?
People with diabetes are at greater risk for serious complications from COVID-19. In general, people with diabetes are more likely to have serious symptoms and complications when infected with a virus, but it also depends on how well each person has their diabetes under control. If diabetes is well controlled and there are no complications associated with it, the risk of becoming seriously ill from COVID-19 is about the same as that of the general population.
Are the risks different between people with type 1 and type 2 diabetes?
In general, there are no known reasons to believe that COVID-19 presents a different risk between type 1 and type 2 diabetes. Age, presence of chronic complications, and degree of control. the self are more important than the type of diabetes. diabetes. People with chronic complications from diabetes are likely to get worse if they contract COVID-19 than people with diabetes who are otherwise healthy, regardless of their type of diabetes.
At this point, the SED shares a handbook of practical and basic recommendations, including rigorous advice and information on various aspects of interest to diabetic patients, among which it emphasizes the importance of exercising one hour a day. and take care of the diet.
Recommendations for diabetic patients
PHYSICAL ACTIVITY
1) Goal: 1 hour a day
Get up and walk around the house. Any business is better than nothing. Light intensity activity can also offset the health risks of a sedentary lifestyle. To counteract the lack of daily physical activity due to confinement and to comply with international recommendations for maintaining good health, the diabetic person is recommended to perform at least 300 minutes of aerobic exercise per week over 5 to 7 days.
2) Add muscle!
Along with its locomotor function, skeletal muscle plays a vital role in diabetes, as it is the main tissue that uses glucose for energy. Therefore, the diabetic person must maintain and maximize their muscle mass through strength training.
3) Exercise benefits the mind
Physical activity is linked to better sleep, better memory, better balance and cognitive skills; Additionally, it is associated with a lower risk of weight gain, dementia and depression. It is one of the most important things a person with diabetes can do for their health and well-being.
SUPPLY
4) now more than ever look at your diet
The SED Lifestyle Working Group has published specific recommendations on feeding during childbirth (available on the SED website). Among them, some basic tips stand out:
Avoid compulsive shopping in supermarkets and above all avoid nutritionally junk foods. Plan and make a single weekly purchase. Although food is not a transmission route for the virus, WHO recommends maintaining good kitchen hygiene. Do not purchase or start consuming food supplements without the advice of a dietician-nutritionist or doctor. Infusions or teas do not protect against infection; they can be useful in case of dehydration. Ensure a correct daily protein intake based on good quality foods, avoiding red meats and sausages and maximizing the intake of plant-based proteins. Adapt nutritional intake to the home birth situation (with less energy expenditure). This is why it is essential to limit the consumption of high-calorie foods and avoid snacks. If additional carbohydrate intake is made, insulin dose calculations will need to be readjusted in the people using it.
DIABETES IN PEDIATRIC AGE
5) diabetic child
Severe forms of coronavirus infection are very rare in children; however, children can be an important transmission belt for SARS-CoV-2 infection, many of whom are asymptomatic.
Children and adolescents with well-controlled diabetes do not appear to be at increased risk of coronavirus infection.
The rules for controlling diabetes are the most common; in case of coronavirus disease, apply the “sick day” advice with frequent blood glucose and ketone checks.
THERAPEUTIC EDUCATION AND ADAPTATION OF DRUGS
6) Diabetes does not increase the risk of getting the infection
The risk a person with diabetes has of contracting the infection caused by Covid-19 is the same as in the general population, although if the infection is acquired, its severity and course may be different, depending on the age. . , the degree of control of diabetes, the presence of chronic complications or other conditions.
7) The more information, the better prevention
Follow the recommendations to avoid the spread of this infection (effective and frequent washing of hands, cough with a tissue in the mouth to throw away or use the elbow, keeping a distance of 1.5-2 meters between people) and follow containment and isolation if indicated. It is essential to know the warning signs (fever, dry cough, muscle aches, shortness of breath), as well as when and where to contact healthcare professionals. Make sure you seek information from valid and contracted sources. It is important to avoid excessive information or false news.
8) What must not be missing at home: medicines and control devices
Have all diabetes care materials, medications and prescription, blood glucose meter, glucose and ketone test strips and contact numbers for the medical team, pharmacy, emergency medical center …
9) Strict blood glucose control is essential
Increase the frequency of blood glucose checks and, if necessary, ketone tests (if the glucose value is above 250 mg / dL twice). Be extremely vigilant and know the warning signs of decompensation (high glucose values, positive ketone bodies, thirst, urge to urinate, etc.), as well as the measures to be taken in these cases and where to contact healthcare personnel if necessary precise (common recommendations against any infection).
* In case of coronavirus infection:
Medication may need to be changed. It is essential to maintain adequate hydration. Don’t stop taking your insulin, especially if you have type 1 diabetes. If you have high glucose levels, you may need to give extra insulin and check for ketones. If you are taking medicines such as iSGLT2 or “glucosuric”, you must stop taking them. If you have repeatedly raised your glucose and ketone levels, contact your healthcare team.
PSYCHOLOGICAL IMPLICATIONS
10) Good care and a positive attitude are essential
It is convenient to adjust the intensity of fear, as this allows you to take appropriate action; Too much fear, in addition to causing suffering, leads to bad decisions. Organizing the day, including personal care and other routines for physical and intellectual development, generates confidence. Combine solo activities with other social / family activities. Avoid giving in to discouragement and thinking that this is a temporary situation that you can come out of stronger.
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