COVID-19 and Diabetes

Patients with diabetes are a high risk group for infection when considering communicable illness and this applies to the Corona virus (COVID 19) currently afflicting the population.

The Corona viruses are familiar to us from previous epidemics in the United States (SARS, MERS) . This latest arrival on our shores has features similar to other Corona family members, but also appears very hardy in being able to survive on some surfaces for days, increasing the likelihood of infection. The family name Corona comes from spikes on the virus that permit it to easily attach to cell surface receptors so that proteins from its envelope and membrane can penetrate and take over the cell machinery. Inside the cell the nucleocapsid (RNA) possesses the information that transforms our cells into factories replicating the virus and releasing its copies into our system to spread the infection in the airways and lung tissue.

The body protects itself through its immune system mobilizing killer cells , antibodies and  chemicals. The immune reaction also involves secretion of gelatinous fluids from our tissues to bind the invaders and delay their progression. In many cases, this response can become part of the problem since fluid-filled airways in individuals weakened by chronic illness or excess weight can exceed their ability to control events and maintain oxygen supply. In such circumstances ventilator support may become necessary as the body struggles to survive the spread of virus throughout the body. Older patients are at greatest risk for unfavorable outcomes. 

Our best defense is prevention. I advise my patients to be well rested and to enjoy balanced meals properly timed respecting our biological clock (see my book A Blueprint for Healthy Eating: Your Diet Guide for the New Millennium). I add vitamin D and zinc to their regimen. These supplements support the immune system and fight inflammation preventing events from spiraling out of control. Certain familiar medications such as hydroxychloroquine  in combination with antibiotics have proven useful in arresting progression of the illness, always under careful medical supervision. Early intervention guarantees the best prospect for recovery.

Screening for the virus is important to identify carriers who have become exposed and can spread the infection without developing symptoms themselves. Measures can be taken to place them under observation for a few weeks before permitting them to meet or serve the public. Those individuals who have developed a fever or other symptoms of a cold can be screened  so that intervention can begin early.

As always , proper hygiene is essential in preventing infection. Decontaminating surfaces, shopping carts and shared devices is important. Seats in mass transit must be regularly sanitized and circulating air must be fresh and clean.  Most importantly, we must avail ourselves of the healing effects of sunlight with every opportunity. Ultraviolet sun rays are the disinfectant of choice in our environment and the generator of vitamin D in our skin.  Face masks and social distancing are also helpful in closed spaces and will remain part of our lifestyle for some time to come.