It is a fact that coronavirus severely infects people who have pre-existing medical conditions. Hence, it is an established fact that people with diabetes are at higher risk of getting infected with corona virus. Diabetic people have poor immune-system that cannot resist the spread of the virus thus aiding the infection to spread faster. Diabetic patients have poor glycaemic control that disables a productive immune response to the viral infection as well as to the bacterial infection in the lungs. Hence, these people tend to develop weak metabolic control after getting infected with COVID-19.

There are various types of diabetes- Type 1 diabetes, Type 2 diabetes and gestational diabetes, all of which show almost similar effects when infected with corona virus. People having any of these types of diabetes are vulnerable to corona virus, however the severity may differ from person to person. The virus may potentially lead to the development of diabetic ketoacidosis (DKA) in diabetic patients. DKA refers to the condition when high levels of fatal acids called as ketones build up in your blood.

When a person has diabetes, and any virus enters the body, your body tries to fight with it by releasing the stored glucose into your blood flow thus providing you energy to resist the attack. However, your body in incapable of producing required insulin, leading to distorted sugar levels. High blood sugar level weakens the immune system and makes it less able to fight with the virus. Your body is fighting the virus as well as the diabetes simultaneously, resulting in your blood levels to go hay-wire. This condition may also lead to some long-term problems related to your eyes, feet and other parts of the body, which cannot be avoided.

Most of the patients with type 2 diabetes are obese and obesity is a big risk factor when dealing with COVID-19. Obese people are prone to get infected especially people with abdominal obesity. Respiratory problems accompany with severe abdominal obesity, hence there are higher chances of severe spreading of virus in suchpatients. These people also have a risk of asthma, frequent exacerbations, resulting in an impaired response even towards the virus.

Diabetic patients should get medical help right away if your body shows any corona-virus symptoms like fever or dry cough. Some of the symptoms for diabetic patients to look out for are:

• Shortness of breath
• Presence of moderate or large ketones
• DKA symptoms- weakness, lethargy or vomiting

Here are some of the guidelines that Diabetic patients should follow to avoid getting infected with COVID-19:

1. Check your blood sugar levels at home more often than what you usually do. If you don’t check at home, keep an eye for symptoms of hyperglycaemia (excessive urine at night, headaches, tiredness or being thirsty). These signs implicitly indicate that your body may be infected by corona virus.
2. Make sure you stay hydrated by consuming unsweetened drinks.
3. Keep eating often
4. For people having type 1 diabetes, it is necessary to check your ketones as well as the blood sugar levels at least once every four hours. If there are any ketones present or if the levels of sugar in blood differ than what your health care provider has suggested, seek medical attention.
5. If you are not able to keep food or drinks down i.e. if you are vomiting, get medical assistance.
6. Diabetic people, infected with corona virus should strictly restrict themselves to social distancing. If you have to go out, make sure you keep at least 6 feet distance from the people and cover your hands and mouth.
7. Don’t forget to wash your hands thoroughly before giving yourself an insulin shot.
8. Avoid sharing your personal items with anyone else in the family, to minimize the risk of spreading of infection.
9. Make sure you stock up on insulin and medical supplies for few weeks in advance.
10. Keep extra glucagon and ketone strips within your reach.
11. Keep emergency contact handy.

Based on the past COVID-19 cases, it is observed that people with diabetes are at higher risk of getting severecorona virus infections, however, your risk of getting very sick is lower if your diabetes is well-managed. If proper guidelines are followed, and if peopleare well-prepared and factually informed, complications can be avoided.