While it is known that senior citizens and people with co-morbidities are at a high risk of contracting COVID-19, doctors in the city are seeing many new cases of diabetes post the infection.

Doctors said diabetes increases the risk of complications and death if COVID-19 is contracted. Nearly 62% of the total 37,648 COVID-19 victims, in the State so far, had either diabetes or both diabetes and hypertension, along with other co-morbidities.

State Health Commissioner K.V. Trilok Chandra told the Hindu on Tuesday that while almost all the patients who succumbed to COVID-19 reported SARI and ILI symptoms, 62% of them had one or more co-morbidities, mainly diabetes and hypertension.

“The State’s death audit committee has found that over 42% of the deaths were due to late reporting. Their underlying health conditions worsened leading to further complications due to late reporting,” the Commissioner said.

New cases

Notably, not only does COVID-19 have the ability to worsen existing diabetes, but the virus may also trigger new cases, said Haleema Yezdani, a diabetologist who has been tele-triaging and tele-treating COVID-19 patients through Emergency Response Team and Project StepOne groups.

“While many non-diabetic patients are reporting symptoms of diabetes post COVID-19, diabetic patients are noticing sudden spikes in their blood sugar levels,” she said.

Pointing out that patients with Type 1 diabetes are noticing more episodes of diabetic ketoacidosis (a complication where the body produces excess ketones) due to COVID-19, she said: “This is because the virus damages beta cells that are found in the pancreas. This prevents the body from making insulin, triggering hyperglycemia (or high blood sugar). Besides, during an acute infection the body is under a lot of stress, causing hormonal imbalance, and an imbalance in insulin secretion,” she said.

The prolonged use of corticosteroids during and after the infection adds to the problem.

Pandemic lifestyle

Quoting a recent survey by the BBMP which revealed that 50.86% of Bengaluru’s population is diabetic, Mahesh D.M., Consultant (Endocrinology) at Aster CMI Hospital, attributed it also to the sudden change in the lifestyle owing to the pandemic and the subsequent lockdowns.

“Lack of physical activities due to confinement to homes has further added to the problem. High prevalence of smoking and increased alcohol consumption and high intake of refined carbohydrates are risk factors. Poor nutrition in early life combined with overnutrition in later life also plays a significant role,” he said.

He said that in the last two-three months, the hospital had come across 150-200 new patients with diabetes. “Prior to the pandemic, it was 75-100 during the same period. With Bengaluru being the IT capital, many people are leading a sedentary lifestyle. The number is expected to rise in the coming years,” he said.

Pre-diabetic state

Pramod V. Satya, consultant internal medicine (certified in diabetelogy) at Vikram hospitals, said pro-inflammatory state in COVID-19 produces hyperglycemia. “Most of the times COVID-19 patients will have a pre-diabetic state (borderline diabetic), which worsens with the infection. Besides, indolent altered sugar metabolism is uncapped by COVID-19 leading to diabetes. In patients who are completely euglycemic (having normal sugars) there is no evidence to prove that COVID-19 causes diabetes,” he added.