Diabetes and COVID-19

June 1, 2020 | Dr. Linda J. Dobberstein, DC, Board Certified in Clinical Nutrition

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 Diabetes and COVID-19
We are in an era when everything is focused on COVID-19. No matter where you look, what you watch or listen to, inevitably some aspect of what you see has been affected by the Pandemic. In your mind is the question - am I or a loved one going to get this disease?

Individuals with underlying health concerns are most at risk of COVID-19, especially those with diabetes. A recent meta-analysis study published May 6, 2020 focused on the concerns associated with type 2 diabetes and COVID-19. These current findings have some sobering findings for those who have diabetes. Even more important, if you have pre-diabetes or diabetes, these findings may perhaps give you even more incentive to take charge of your health now more than ever.

Study Findings – Diabetes and COVID-19

This meta-analysis study evaluated 33 recent COVID-19 studies which included 16,003 patients from three different continents. This is the largest meta-analysis study so far on COVID-19. In comparing all other health concerns, statistics showed that individuals with diabetes who became ill with the virus had more ominous outcomes compared to other underling disorders.

Study results showed that diabetic patients with COVID-19 were twice as likely to develop severe COVID-19 and twice as likely to succumb to the illness. They were more likely to develop acute respiratory failure requiring invasive ventilation and ICU care. Diabetics were at higher risk for severe pneumonia, uncontrolled inflammation, and increased blood coagulation which leads other risks.

It is well-understood that diabetes is also a major cause of other conditions that cause increased illness and death. That includes obesity, heart disease, stroke, fatty liver, high blood pressure, and kidney disease. These are other factors that increase the risk for COVID-19 infection, but in this meta-analysis, the main concern identified was diabetes.

Fifty Percent of Those with Diabetes Don’t Know It 

An estimated 463 million people in 2019 across the globe have diabetes. By 2030, diabetes is expected to affect 578 million people. An astonishing one in two individuals do not know they have diabetes. The highest numbers of diabetics are found in urban settings and high-income countries rather than rural areas and low-income countries. Type 2 diabetes is not just a disease of old age; it affects adolescents, teenagers, and young adults too.

Elevated Blood Sugar Symptoms

Type 2 diabetes may not cause symptoms until much later in the disease progression. Symptoms may include increased thirst and hunger, frequent urination, fatigue, blurred vision, fatigue, numbness and tingling in feet, erectile dysfunction in men and loss of menstrual cycle in women, frequent infections, darkening of the skin in arm pits and around the neck, and slow healing sores.

Hemoglobin A1C levels, fasting blood glucose, glucose tolerance tests, urinalysis, serum insulin and other lab tests may be done to evaluate blood sugar concerns and status. Get your fasting blood sugar and A1C levels tested at least once per year especially if you are sedentary, have a poor diet, smoke, have hypertension, and/or are overweight.

Normal fasting glucose levels are from 70-99 mg/dL. Prediabetes/impaired fasting glucose is from 100-125 mg/dL. Diabetes is 126 mg/dL and above on more than one test.

Normal A1C levels are 3.9 – 5.5 mmol/L. Prediabetic/impaired fasting glucose is 5.6 to 6.9 mmol/L. Diabetes is diagnosed at 7.0 mmol/L and higher on more than one test.

Diabetes Dysregulates Your Immune System

Diabetes is more than just extra sugar floating around in your blood stream. It affects all the tissues in your body including your immune system. In diabetes, immune cells that normally clean up debris and fight off germs are impaired. The ability to clear out viruses or other microbes is dysfunctional while production of inflammatory cytokines is increased.

Seventy percent of your immune system is in your digestive tract with your gut flora which directly impacts your respiratory tract and its own microbiome. COVID-19 gains its entry in the respiratory tract, but also gains a foothold in the gut creating or worsening intestinal permeability.

Gut dysbiosis or overgrowths of non-beneficial bacteria and Candida/yeasts in the digestive tract are also common findings in individuals with diabetes. These concerns further tax your immune system’s vitality in fighting germs, cellular clean-up, inflammation management, and detoxification. This means if you have underlying gut problems, your immune barriers and warriors are compromised, like trying to fight with one arm tied behind your back and blindfolded.

Take Inventory 

Type 2 diabetes is substantially influenced by diet and lifestyle especially in early stages. Now is a great time to take inventory of your habits and really own up to them. Think about the long-term status or lifetime consumption that you have with some bad habits. Are you in the habit of having a treat or dessert at every meal or daily indulgence of a frappe or cappuccino? Think about how many cases of soda pop you have consumed in your lifetime? Or how many boxed cake or brownie mixes or gallons of ice cream you have made and consumed? Or how about you growing up or your kids with a focus on mac and cheese, ramen noodles, mounds of French fries or processed fast foods? How does that compare to meals with whole fruits and vegetables, grains, seeds and nuts, and quality free-range meats? Everything counts on this journey of life!

Inventory Your Steps

The next step is to literally take inventory of your steps. How physically active are you? As a society we are far less active than generations before us. For many the routine is - you get up in the morning, drive to work or walk a few steps to the computer in your home office. You sit at a desk or on the couch with your device for 8 or more hours per day. Then you go home, have a big meal and then sit in the front of the computer or TV again for a few more hours.

Maybe there is a walk or some light stretching somewhere in the day’s routine. Maybe some light chores are included. These activities are far less than the gardening, manual cutting of grass, hauling water or wood, manually kneading breading or other household or farm chores that your parents or grandparents performed every day. Count your steps. Sitting too much is deadly.

Several other aspects and tools exist and apply to type 2 diabetes and health management. My goal is to get you to focus on things that you can immediately change. No matter what the current threat or concern is of the day, the goal is to make as many good choices as you can for the duration of your life. The occasional treat or dessert is okay in moderation with a meal if you have overall healthy dietary habits and lifestyle.

Take some time to view your patterns, be accountable to yourself and your loved ones. By the time you get to the diagnosis of type 2 diabetes, your body has been dealing with unhealthy dietary and lifestyle habits likely for decades. Even children and adolescents today have type 2 diabetes, whereas 30 years ago, it was nearly nonexistent.

COVID-19 isn’t going away as fast as it arrived. However, this is a time when you can take back your health. Use this Pandemic as an incentive to make changes for you. So many other changes have been enforced and more are likely to come from the government and officials in authority. You however can make your own personal choices for how you decide to treat yourself and your family.

Make the choice to change one dietary habit and food choice that you know is not helping you, i.e. exchange the Frappucino with 60 grams of sugar for a healthier choice. Get rid of the soda pop in exchange for a sparkling mineral water.

Rather than reaching for comfort food after a day of hearing more COVID-19 statistics or other distressing news, focus your attention on some thing that you can change. Keep your focus on things that you can change, rather than things that you cannot change. Learn about and implement The Five Rules of The Leptin Diet.

Focus on learning a new exercise, maybe some dance steps or set a goal for your own personal record for an exercise. Maybe its gardening and yard maintenance. Try something that requires hand-eye and balance coordination, i.e. throwing a small ball against the wall and catching it. Engaging your muscles and nerves in manners different than your daily routine is essential to aging well.

In addition, the activity of your sympathetic nervous system with physical exercise directly helps your pancreas, liver, and muscles manage insulin and blood sugar. This engagement of the sympathetic nervous system with high intensity interval training (HIIT) or burst training, strength training, or a good endurance work-out is different than the chronic low grade hold-your-breath, hunched over desk, worried, irritable state that also engages the sympathetic nervous system.

A short leisurely stroll around the block does not typically healthfully engage the sympathetic nervous system to burn blood sugar and help insulin compared to other types of exercise but it is far better than no activity. Be physically active outside. The hues, colors, and scents of nature help your immune system and your microbiome.

Be inspired by stories like that of Captain Tom Moore, a 100-year-old British World War II veteran. In late April 2020, he walked 100 laps of his backyard garden in Great Britain walking with a walker, after a recent hip replacement, and cancer survivor to give back and to help others during this Pandemic.

Tell a friend or family member about your new goals so they can celebrate with you as you make progress, but to also keep you accountable when the going gets tough. Use as many tools as you need to help you better manage your blood sugar, so it doesn’t get the best of you.

Helpful Articles and Resources

What is the Leptin Diet?

The Leptin Diet Weight Loss Challenge #1 – Overview and Basic Needs

This is Your Brain on Pop 

New Research Links Cancer to Sugar Intake 

Sugar, Not Salt, Harms Bones and Strips Out Minerals

Exercise Tips to Improve Leptin & Fat Burning

Blood Sugar Affects Heart Rhythm

Leaky Gut Syndrome: More Than Just a Gut Problem

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