IssueNov 21Opinion

Diabetes and COVID-19 vaccination

Getting vaccinated whether you are a diabetic patient or not is critical and is the most viable solution to get protected against the virus. Dr Anoop Misra,Chairman, Fortis CDOC Center of Excellence for Diabetes at New Delhi, reveals more

Now that COVID-19 pandemic seems to mellow down its effect on people living with chronic medical conditions such as diabetes have come into focus. These people are at increased risk of severe symptoms and  complications from the COVID virus.

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It has been reported that those who have been admitted to the hospital for COVID-19 were also found to have new cases of hyperglycaemia or high levels of blood sugar, with some persisting beyond infection. During the first and second pandemic waves in India, new cases of diabetes have been linked to COVID-19, with some recovering from the virus but have developed “fullblown diabetes” with no known risk factors or health concerns.

Impact of COVID-19 for people with diabetes
According to the American Diabetes Foundation, the impact of COVID-19 in people with either type 1 or type 2 diabetes can vary with their age, complications and condition. Recent cases have also shown that people who
already have diabetes-related health problems are likely to have adverse outcomes to COVID-19, whichever type of diabetes they have.

Diabetes and COVID-19 vaccination
Vaccine Hesitancy in people with diabetes has prompted health organisations such as the International Diabetes Foundation to publish related guidelines. One of the things reported is that that vaccination can lead to a sudden spike in blood sugar. Such cases need more scientific observation and study however the safety of COVID-19 vaccines has not been disputed in diabetic patients. In fact, there is not enough evidence as of now regarding the efficacy of the COVID-19 vaccines for diabetic patients or which type of vaccine is the best option. But one thing is certain: getting vaccinated whether you are a diabetic patient or not is critical and is the most viable solution to get protected against the virus. The cases we have observed in India so far are self-limiting and does not require major changes in treatment for diabetic patients. It is also worth noting that elevated blood glucose levels are common among patients taking dexamethasone, a steroid that is a front-line treatment for COVID-19. Then again, it is better to wait for further clinical investigations to support these findings.

Having said that, following a good monitoring routine has always been the key to prevent any untoward events
for diabetic patients and it is important to be watchful of sudden increases in blood sugar or blood pressure.

Improving General Acumen
Currently, the general practitioners manage primary care for diabetic patients. As one of the countries with
the highest number of diabetic patients globally, clinicians in India need to be abreast with the latest response against diabetes based on prevention, early diagnosis, and a proper treatment plan.

For example, while existing clinical guidelines provide best practices for diabetes management in primary care, the body of research related to COVID-19 and vaccination is evolving day by day. Because clinical knowledge
is never static, clinicians must quickly adapt and apply this new knowledge to deliver the best possible care. It is critical to better equip clinicians with easy and timely access to evidencebased information.

Going forward
It is quite clear that diabetic patients are at an increased risk of having severe complications from COVID-19.
Vaccination can help. Leveraging the latest evidence-based information is vital to improving primary care
especially if clinicians are looking to monitor patients remotely.

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