Diabetes and COVID-19

Diabetes is a major risk factor for heart disease and consequently many people living with diabetes are also living with heart conditions. It is unclear if having diabetes puts you at greater risk of contracting COVID-19 than anyone else, however it does increase your risk for complications if you contract the virus. Recent data from the Department of Health has highlighted that 23% of all ICU admissions due to COVID-19 have underlying diabetes. Having diabetes causes the body to raise glucose levels during times of illness or stress which makes it more difficult to fight infection.

To reduce your risk of contracting COVID-19 you need to be extra vigilant by following the advice of the HSE and taking the recommended precautionary measures. You should be aware of the signs and symptoms of the virus, and if do become unwell phone your doctor to arrange an assessment and testing.

Be prepared

Be extra attentive to your glucose control and monitor on a regular basis if you have a blood glucose monitor. Regular monitoring can help avoid complications caused by high or low blood glucose levels. Ensure to have a supply of quick acting carbohydrates if your blood glucose levels drop, these include non-diet sugary drinks, fruit juice, jelly babies and glucose tablets.
There is no disruption to the supply of medicines and therefore there is no need to order more medicines than you need. However, you should make sure you have a 2 week’s supply. Supplies should include ketone strips if you have type 1 diabetes and an insulin pen if you use an insulin pump in case of pump failure.
Ensure you have a sick day regime to follow. This is a plan that has been agreed between you and your health care provider, with information and advice about how you should manage your diabetes if you become unwell. If you don’t have one you should contact your GP for advice.

Diet and emotional eating

A healthy, balanced and varied diet is important for everyone, but especially so for people with diabetes. During these uncertain times, you may find it more difficult to maintain a healthy diet. With more time at home, increased stress and worry, and reduced activity, you may find that your normal food intake has changed and diabetes management has become much more challenging.

It’s important to keep to a structured meal pattern as much as possible. Here is where a little planning will go a long way. Try to jot down a general plan of meals and snacks for the week ahead, and base your shopping list off of this.

Generally, aim to have 3 main meals, spaced throughout the day with 1-2 healthy snacks if needed. However, if you find you have a reduced appetite you may be under-eating, it can be best to have a “little and often” approach such as 3 smaller meals with 3 more nutritious snacks that are higher in energy. Both approaches will not only help to stabilize blood sugars throughout the day, but will also help you keep your appetite, or physical hunger levels in check. This in turn will help to prevent under or over eating. See our list below for snack ideas.

Healthy low calorie snack ideas:
• A piece of fruit and low fat plain yoghurt
• Hummus and vegetables
• A small handful of nuts (30g)
• ¼ avocado on 2 rice cakes
• Hard- boiled egg
• Low fat cottage cheese with fruit

Higher calorie snack ideas:
• Full fat Greek yoghurt with nuts and seeds
• Peanut butter on wholegrain toast
• ½ avocado on 4 rice cakes
• A 200ml glass of full fat milk
• A matchbox of cheese on wholegrain crackers

For healthier sweet treats that have less impact on blood sugar levels:
• Home baking using zero calorie sweeteners such as Stevia or Canderal
• Sugar free jelly
• A couple of squares of dark chocolate
• Low fat Greek yoghurt with peanut butter and raspberries
• Sugar free soft drinks

It is important to stay hydrated and aim to drink about 2 Litres of water per day. For those trying to increase their appetite, it is best for now to avoid too much caffeine and artificial sweeteners as these can suppress appetite.

Exercise

Continuing to exercise is beneficial for your physical and mental health and importantly it helps improve diabetes control through the lowering of blood glucose levels. If you previously went to the gym or swimming, consider cycling or walking but be sure to follow social distancing recommendations and stay within 5km of your home. You could also try one of our online exercise programmes.

If you take medications that put you at risk of a hypo (this is when your sugar levels become too low and you can feel unwell) make sure you carry a fast acting carbohydrate snack and monitor your blood sugar levels as you normally would.
Ensure you check your feet after exercise for red marks and blisters, this is because individuals living with diabetes often have reduced sensation in their feet and are at increased risk of foot infections and injury.

Routine appointments

Many appointments have been cancelled or postponed due to the COVID-19 outbreak, this is to reduce the risk of infection for both patients and staff members. If you were due to attend for retinal screening, chiropody or your annual diabetes review, your appointment will be rearranged once it is safe to do so. However, your GP is still available and you should phone if you have any concerns, questions about your medication, or if you notice or develop any of the following:
• Changes to eyesight
• Consistently high or low blood glucose readings.
• Red, bruised or broken areas to your feet
• Signs of infection or you become unwell

Medication

You should continue to take your diabetes medication as normal. If you have any concerns it is important that you link with your GP who will connect you with the Diabetes team where necessary.

Further information

Further information on COVID-19 and diabetes can be found here:

2018 World Diabetes Day #FamilyandDiabetes

The 2018 World Diabetes Day is happening on Wednesday, November 14, 2018. The campaign is led by the International Diabetes Federation, and the theme for 2018-19 is Family and Diabetes.

The primary aim of the 2018–19 campaign is to raise awareness of the impact that diabetes has on the family and to promote the role of the family in the management, care, prevention and education of the condition.

The number of people with diabetes in Ireland is growing rapidly, with the total number estimated to be 225,840.

Meet Nicola Delaney, a 38-year-old mum from Co. Tipperary. Nicola is a diabetic and a Croí programme participant. We asked Nicola to share her story in recognition of #WDD2018:

“Before, I didn’t take my health too seriously. I was borderline diabetic for years… then I was diagnosed with diabetes eight or nine years ago. I was referred to Croí for support and it really gave me a kick in the backside!”

“I finally took a stand for my health, and I feel so much better…better health, happier, overall improved. I am more mindful around my diet – why am I eating this? What are the benefits or the risks? I see it with my 12-year-old son, too. He wouldn’t eat fruit before, and now I can explain to him and educate him about food,” says Nicola.

Nicola’s words of support are “Don’t be too hard on yourself. Get help – go to your GP or Croí. There are so many resources available online too.”

#FamilyandDiabetes

Diabetes can increase your risk of heart disease or stroke. This is why the target levels for blood pressure and cholesterol are lower for people with diabetes than for other people.
Knowing the symptoms and risk factors for diabetes is important as non-diagnosis can seriously affect your quality of life. Undiagnosed or poor controlled diabetes can damage your heart, arteries, eyes, nerves and kidneys leading to serious health problems for you and your family to cope with.
You need to pay careful attention to keeping blood sugar levels in your target range and have regular check-ups for cholesterol and blood pressure. Take your medications as prescribed and try to get to and stay at a healthy weight. If you are having difficulty managing your diet, ask your GP to refer you to a dietitian for advice and support.

There is great potential to prevent type 2 diabetes in high-risk individuals by lifestyle intervention. In order to reduce the risk of developing Type 2 diabetes, it is recommended that all people have a healthy balanced diet, take regular physical activity and attain a weight appropriate to their height.

You are more at risk of getting Type 2 diabetes if you are:
• Over 40 years of age
• Have a parent or brother/sister with diabetes
• Had diabetes during a pregnancy
• Are overweight for your height
• Do not take 30 minutes of physical activity daily
• Have high blood pressure
• Have high cholesterol

And/or recognise any of these symptoms:
• Blurred vision
• Fatigue, lack of energy
• Extreme thirst
• Frequent trips to the bathroom (urination) especially at night
• Rapid and unexplained weight gain or loss
• Frequent infections
• Numbness, pain or tingling in your hands or feet

The more risk factors or symptoms that you have the more likely you are to have diabetes or pre-diabetes. Take the risk test now at www.diabetes.ie/risk

Continue reading at www.diabetes.ie