‘Uncontrolled Diabetes Has Worst Outcome For COVID-19:’ Dr Mohan
Dr V Mohan on how patients with diabetes, hypertension and Vitamin D deficiency should be cautious.
Video Editor: Deepthi Ramdas
“With uncontrolled diabetes, the chances of you getting a worst outcome of COVID-19 is more, so always keep your blood sugar in check.”
In a conversation with FIT, Dr V Mohan, chairman and chief of Diabetology at Dr Mohan’s Diabetes Specialities Centre, explained how patients with diabetes, hypertension and Vitamin D deficiency should be cautious during this coronavirus pandemic.
Findings of COVID-19 deaths point towards an increased mortality for those with co-morbidities. He explained that the infectivity with COVID-19 is much lesser compared to measles, small pox and others. “This is a set of people who are more vulnerable because apart from these issues, they are older, have asthma, hypertension, heart disease and COVID-19 just adds to the stack” he said. “If you have high sugar, it is a good medium for the virus to grow,” he added.
During this lockdown, should blood glucose levels be tested more frequently than usual?
Absolutely. Otherwise, you won’t know if your sugar is under control. Because of staying at home two things happen. One, lack of exercise. Two, people tend to snack a lot. So do continuous monitoring and tele medicine is being provided by doctors across the country.
You can use a continuous glucose monitor, which is a small patch that you can put on your arm. It has a hair-like part which is a sensor which will continuously record over 100 blood sugars a day.
Should people with diabetes be stocking up on insulin?
People who are insulin - dependant have to because, you will die if you don’t take it. Even if the person doesn’t take for a day, he can go into coma. Keep two to three months of stock in case there is a shortage of supply.
Young people are also affected by Type - 1 diabetes and there is also diabetes of young age. What is your advice to them during the COVID situation because older because we have seen more severe form of COVID in diabetes and immune suppressed people?
In India and other countries, like US, Italy, Spain, we have not heard of too many Type-1 diabetes. So I used to say, this is because they are young, have immunity and are taking insulin. They don’t have other co morbidities. But few days ago, a study from UK, which looked at (data from) NHS (National Health Service), showed a huge number of deaths among Type-1 diabetes than Type-2 diabetes. So I don’t think we can take anything for granted. So everyone needs to be cautious and keep a close check.
What is the best workout you recommend for diabetes patients?
One, aerobic exercises which can be walking, swimming, jogging, running, dancing - anything which involves you moving around.
Two, resistance training. Lift weights, say 2-4kg, to exercise your biceps, triceps and back. Once your muscle is built up, your immunity will automatically go up.
Three, flexibility. You must be able to stand in one leg by folding the other one without falling.
Four, pranayama. Do breathing exercises everyday. You will grow younger as this is reverse ageing. Your muscles, brain and your heart will be younger.
Usually people step out for long hours but now during the lockdown there is no exposure to the sun, so will this affect one’s body?
We just published a paper in the British Journal of Nutrition. We studied 1,500 people in Chennai, through random sampling and what we found was 55% of the population had Vitamin D deficiency. In diabetic people, it was 63% and among obese people it was 80%. So it is really common. And so it is essential to keep a check on the levels.
How can one check Vitamin D levels?
If you have Vitamin D deficiency, you are the one who does badly, just like someone with diabetes. So get a check done. Eat fatty fish, egg yolk, cod liver oil, beef liver. And for vegetarians, eat mushrooms, fortified foods like some milk, cheese, yogurt. You can get sachets of 60,000 international units of Vitamin D, just dissolve it in milk and have this once a week, for four weeks. Then Vitamin D levels will come to normal.
Is it okay to take walks in the garden or on the streets wearing a mask?
Wait for some more time as now is the time people are coming out. If you have a facility to walk on your terrace, garden, if you have a treadmill. You can do yoga, indoor exercises, dancing, spot jogging. Whenever you get a call, walk and take the call.
How can one boost their immunity?
It starts with a good diet. Take more protein as it builds your muscle and immunity. Avoid carbohydrates in large quantities, as it develops insulin resistance. And once that happens, low-grade inflammation sets in. Double your protein intake, halve your carbohydrates. Take a lot of leafy vegetables which will give you a lot of iron, Vitamin B12. Vitamin C us very good and for that you can take it with amla, gooseberry, oranges, kiwi, broccoli. Saturated fats are not good. Any nuts and seeds are good. In a plate, half of it should be vegetables, quarter should be protein.
For non vegetarians, it can be fish, chicken, white of the egg, lean meat. For vegetarians, it is bengal gram, green gram, black gram. For vegetarians, it is bengal gram, green gram, black gram, soya, mushrooms. And only quarter of the plate is for rice or chapatis.
It is very important to sleep enough. Six to eight hours is what is recommended and over sleeping is also not good. That is why they say early to bed, early to rise makes us healthy, wealthy and wise.
Do Indians have ‘increased immunity’ for coronavirus?
We don’t know. It could be very well because in India we are exposed to so many viruses everyday. India is a very young country as 50% of our population is less than 25 years of age, and they have a good immunity. Also, the virus strain, which has come to India has probably a low death rate. That is what is reflected in the numbers.
It is matter of creating herd immunity because the only way it (coronavirus) is going to go away, is if a certain number of population is infected. And amongst the infected cases, most of them are even unaware that they have contracted the virus.
The statistics of cases of coronavirus has been worrying. What is your advice to people during this time ?
Take a risk and get on with your lives. Anyway, your risk is low and even if you get COVID, your recovery is very high. Social distancing, wearing masks, washing hands should continue for another six months. Avoid parties and travel and try to do everything through video conferencing, staying at home. Stay safe and don’t load yourself with news about corona. Remember, this too shall pass. We can tell our grandchildren we lived through these times.
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