The link between COVID-19 and diabetes

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Experts weigh in on why people with diabetes are more likely to die from Covid-19 than any other high-risk group. 

The latest Covid-19 mortality data have revealed that diabetic people are more likely to die from Covid-19 than any other high-risk group.

General Practitioner Dr Mabowa Makhomisane says the reason is that diabetes severely affects the immune system. 

“Diabetes is one of those illnesses we call immunosuppressive diseases. It affects pretty much all the systems in the body, starting from the blood vessels, the eyes, the kidneys to the heart, but also your immune system. So, your immune system becomes weak when you are diabetic. That is why when you are diabetic and you have a wound, that wound takes longer to heal and you find that most of the time they have to amputate wherever that wound is. 

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“COVID-19 tends to overpower the body if it finds somebody who has diabetes,” he says. 

This is why people who suffer from diabetes must take precaution and ensure they don’t put themselves at risk of contracting the virus. 

“Once they get the disease, it becomes difficult for us to stop the progression of the disease to become severe and ultimately lead to death,” says the doctor. 

However, he adds that there are drugs that have been found to help diabetic patients not to succumb to death due to the virus. 

“There have been drugs such as Dexamethasone that have shown to have some effect in terms of reducing death in patients with diabetes.” 

Dr Makhomisane says the drug has shown to decrease the chances of death for people who have the severe form of diseases by 35%. 

Contrary to popular belief, the doctor says not suffering from diabetes does not mean you are at a lesser risk of contracting the virus than the person who has it. The issue is how your body will react to the virus. 

“People who suffer from diabetes are not at a higher risk of contracting the virus but are more at risk of dying from it because people with COVID-19 cannot fight off the infections as well as somebody who doesn’t have diabetes,” he adds. 

He says in recent years, there has been an exponential growth of people who suffer from diabetes. He says this is because “our diet has completely changed from what it used to be. People are eating a lot of processed foods.” 

He says this causes insulin resistance. “So, the body starts building a lot of fat around the body cells and then the body is now unable to absorb the sugar into its cells. When the sugar remains in the blood system for too long, it starts causing damage to the blood vessels.

“Because of the fat that is aligning on the cells, sugar cannot go into the cells. Then the body starts producing more and more insulin to push this sugar in, but the more you produce the insulin-producing cells start working on overdrive and they die. Once they die, then you don’t have insulin, then you have a lot of sugar in your system,” says the doctor. 

He warns that obesity is one of the leading causes of diabetes. 

Dietitian Sylven Masoga says patients diagnosed with Diabetes Mellitus need to follow the South African Food Based Dietary Guidelines (SAFBDG). These guidelines encourage, amongst other things, a healthy eating plan. He says attention should be paid to the quantity of the food eaten. The plan encourages Diabetic patients to eat smaller, frequent meals in order to avoid too much release of glucose from foods in the gastrointestinal tract (GIT) into the body system.

For instance, starchy foods should be the size of the fist folded. 

He says the meat (especially red) should not be more than the size of the palm. “Additional to this, they must eat more of fruit and vegetables,” says Masoga. 

He adds that vegetables and fruit should be eaten with the skin or peels on to get the best nutrition and fiber from them. 

Masoga adds that vegetables that cannot be eaten with the skin on, should be boiled with their skin to ensure no nutrients are lost. He says the skin has fibre.

The dietitian warns against consuming fatty foods, or the frequent frying of foods.

“Trim off saturated fats to minimise predisposition to insulin resistance. Individuals may opt for lean meats to better control their blood glucose levels within acceptable limits,” he concludes.