Doctors Warn Against Neglecting Diabetes Medications During Pandemic

Healthcare professionals are urging elderly diabetes patients to take their medications regularly during this period of COVID-19 pandemic to avoid serious complications. Ophthalmologists warn that if left untreated, diabetes could damage many of the blood vessels including the retina that is responsible for sight.

What to know

“Diabetes makes you one and a half times more likely to get glaucoma and two times more likely to get cataracts and both can lead to blindness,” says the British Diabetic Association.

People should monitor these conditions regularly and ensure they always take their drugs. They should also watch what they consume.

Advice from an ophthalmologist 

A consultant ophthalmologist, Dr. Adegboyega Alabi, Chief Operating Officer of Me Cure Eye Centre in Lagos, Nigeria warned that elderly diabetes patients with chronic conditions like hypertension, stroke, and kidney disease, among others, must ensure they manage those conditions properly because of the impact of the ongoing COVID-19 pandemic.

Some people with diabetes develop serious complications with their eyes, called diabetic retinopathy. This is when high blood sugar levels cause damage to blood vessels in the retina. If treatment is neglected for too long, partial or total blindness may occur.

Eye facilities are not performing elective surgeries

“The way the elderly people access care has reduced and eye facilities have scaled services,” said Alabi. 

Dr. Alabi urged those with eye problems, such as glaucoma, to get surgical intervention on time, warning that failure to do so could result in permanent blindness.

Note: Blindness from glaucoma is irreversible.

“Diabetes leads to hyperglycemia where there is high glucose in the bloodstream. This damages the blood vessels.When the blood vessel is damaged, it affects the work that it does. We have a blood vessel for the eye, skin, kidney, and others. Accumulation of glucose in the blood leads to breakage of these blood vessels. They can burst. If it happens in the eye, especially in the retina, there will be a problem. It is called diabetic retinopathy and can lead to loss of sight. Compromised blood systems could lead to retinal glaucoma and retinal detachment. It also leads to the formation of a cataract boil on the eyes,” Dr. Alabi explained.

Diabetes and Coronavirus FAQ

Are people with diabetes more likely to contract COVID-19?

There is not enough data to show whether people with diabetes are more likely to get COVID-19 than the general population. The problem people with diabetes face is primarily a problem of worse outcomes, not greater chance of contracting the virus.

Do people with diabetes have a higher chance of more serious complications from COVID-19?

People with diabetes do face a higher chance of experiencing serious complications from COVID-19. In general, people with diabetes are more likely to experience severe symptoms and complications.

NOTE: Risk of getting very sick from COVID-19 is likely to be lower if your diabetes is well-managed. 

When people with diabetes do not manage their diabetes and experience fluctuating blood sugars, they are generally at risk for a number of diabetes-related complications. Having heart disease or other complications in addition to diabetes could worsen the chance of getting seriously ill from COVID-19, as well as contracting other viral infections because your body’s ability to fight off an infection is compromised. This is why diabetics are grouped into the category of immunocompromised. 

Viral infections can also increase inflammation, or internal swelling, in people with diabetes. Inflammation is also caused by above-target blood sugars, and both could contribute to more severe complications.

Do I need to worry about DKA (diabetic ketoacidosis) during the pandemic?

When sick with a viral infection, people with diabetes do face an increased risk of DKA (diabetic ketoacidosis), commonly experienced by people with type 1 diabetes.

Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can’t produce enough insulin.

DKA can make it challenging to manage your fluid intake and electrolyte levels, which is important in managing sepsis. Sepsis and septic shock are some of the more serious complications that some people with COVID-19 have experienced.

If your blood sugar has registered high (greater than 240 mg/dl) more than two times in a row, check for ketones to avoid DKA.

What are the symptoms and warning signs I should be watching out for—and what do I do if I think I’m developing them? 

Pay attention to potential COVID-19 symptoms including:

  • Fever
  • Dry cough
  • Shortness of breath
  • Chills
  • Repeating shaking (from chills) 
  • Muscle pain
  • Headache
  • Sore throat
  • New loss of taste or smell

If you feel like you are developing symptoms, call your doctor. When you call:

  • Have your glucose reading available
  • Have your ketone reading available
  • Keep track of your fluid consumption (use a 1-liter water bottle) and record intake
  • Be clear on your symptoms (i.e. nausea, stuffy nose, dizziness, etc.)
  • Ask your questions on how to manage your diabetes

What are the emergency warning signs—and what should I do if I’m experiencing them?

If you develop emergency warning signs for COVID-19, get medical attention immediately. In older adults, emergency warning signs look like:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Blue-colored lips or face

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