COVID-19 diabetes update from a doctor: expert advice on how to keep safe

We asked Prof. Joel Dave, one of SA’s top endocrinologists and one of our Panel of Experts, for an update on the COVID-19 situation for people with diabetes in South Africa. Here’s what he had to say…

COVID-19 diabetes update

As South Africa has eased slightly beyond level 3 lockdown, I thought it would be a good time to give you a COVID-19 diabetes update. Here’s what we currently know about diabetes and COVID-19 in South Africa. All the scientific evidence at the moment is just a description of what doctors and researchers have been seeing in various parts of the world and what we are now seeing in South Africa, and especially the Western Cape, now the centre of the pandemic in South Africa. 

Does diabetes increase the risk of getting COVID-19?

There is still no reliable scientific evidence to show that people living with diabetes (PLWD) are at increased risk of getting infected with COVID-19.

Do people living with diabetes have a greater risk of complications from COVID-19?

YES.  Studies from around the world have shown that when a person living with diabetes is diagnosed with COVID-19, their risk of complications increases. They have a greater risk of needing to go to hospital, intensive care and ventilation.  We are seeing this as well in the Western Cape.

People with diabetes have a much greater risk of being admitted to hospital and needing the intensive care unit.  Unfortunately, we are also seeing that they are at much greater risk of death due to COVID-19.  Age and body mass index (BMI) also play a major role. More severe COVID-19 is associated with increasing age and increasing BMI – being overweight or obese. (Here’s a handy calculator to figure out your BMI and if you’re at risk.)

Everyone’s risk is different and will change depending on diabetes control, BMI, age and other co-morbidities (more on that below).

The good news is that the majority of people living with diabetes will still only have mild COVID-19 that can be managed at home and they will make a full recovery.

Prof. Joel Dave, endocrinologist

Does controlling your diabetes matter?

YES.  Studies are beginning to show that people with diabetes who are admitted with COVID-19 and have well-controlled diabetes do clinically better than those with poorly-controlled diabetes. Information from the Western Cape is now also beginning to show that well-controlled diabetics have less severe COVID-19 than those with poor diabetes control.

Keep your diabetes in good control by eating healthy food, taking your medication, doing some exercise every day, and losing weight if you need to.

What are the other risk factors for complications in people who get COVID-19?

Many studies now show that certain things increase the risk of complications due to COVID-19. Being older than 65 years old, obesity, hypertension (high blood pressure), coronary artery disease (previous heart attacks or stents), cancer, smoking and lung disease.

Is there a difference between patients with Type 1 diabetes (T1DM) and those with Type 2 diabetes (T2DM)?

At the moment, there is still no clear data on this. People with diabetes are at greater risk than people without diabetes.  The presence of the other risk factors mentioned above can also change the risk whether you have Type 1 or Type 2. Age and BMI seem to play a major role, so if a person is older and overweight, then it doesn’t matter what type of diabetes they have.

Is there anything that you can do?

Yes.  I would like to urge you to please focus on keeping your blood sugar in your target range as much as possible. (In general, this means between 4mmol/l and 10mmol/l, but your doctor might want you to be in tighter control). Keep your diabetes in good control by eating healthy food, taking your medication, doing some exercise every day, and losing weight if you need to.
 
I would still continue to encourage people with diabetes to self-isolate as much as is reasonably possible.  It’s all about finding the balance between the risk of infection vs the risk of losing a job and needing to earn an income vs the risk of seeing a friend or meeting for a cup of coffee! These are all very important factors in our daily lives but, at this time, may cause someone to come to harm. 

If you do have to be exposed to others, then please be very strict about hygiene measures. Wear a face mask, wash your hands, social distancing of 2 metres, don’t touch your face and, if you have to get close to another person, consider using a face shield. 

Remember the symptoms of COVID-19: fever, cough, shortness of breath, muscle aches and pains, loss of smell and/or taste, diarrhoea. If you develop any symptoms, please contact your GP urgently to organise to be tested for COVID-19. You can also use the South African WhatsApp support line for more information: 0600-123456

We are all in this together.

What to read next?

• The one article you should read about COVID-19 and diabetes
• Should diabetics get the COVID-19 vaccine? 
• What the research tells us about COVID-19 and diabetes
• What do we know about COVID-19 and diabetes?
• COVID-19 diabetes advice from a doctor
• Fast facts about diabetes and COVID-19
• 12 COVID-19 precautions and tips for people with diabetes
• Free COVID-19 resources for people with diabetes
• 10 diabetics share how coronavirus affects their diabetes
• Diabetes survivors of COVID-19

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