The indiscriminate use of steroids to treat Covid-19, stress and the virus’s effect on pancreas is making patients’ blood sugar levels shoot up, cases have particularly increased in the past two weeks
With stress being one of the major factors, doctors have advised Covid-19 patients against panicking. Representation pic
While Mumbai is known for the high number of diabetics, Covid-19 and its treatment are leading to a further jump in cases. City doctors are seeing in what they term as ‘Covid-19 diabetes’.
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Rita Das, 61, a Mulund resident, was surprised when doctors treating her for Covid-19 said she has uncontrolled blood sugar levels and put her on insulin. Das was diabetes-free before Covid-19.
Das’s case is not the only one in the city. Indiscriminate use of steroids, stress and the virus attacking the pancreas are increasing the cases, say Mumbai endocrinologists. They say that there needs to be more awareness and strict monitoring of blood sugar levels.
Dr Shashank Joshi, diabetologist and core member of Maharashtra’s Covid-19 Task Force, acknowledged the rise in Covid-19 diabetes cases in the past two weeks. “We are currently dealing with four groups related to Covid-19 and diabetes. The first group includes people with diabetes who get Covid-19. The virus and the steroids used to treat it give them high blood glucose levels. Second group includes people with borderline diabetes or pre-diabetes. When they get Covid-19, it triggers full-blown diabetes. The third group is of people who have no family history of diabetes or pre-diabetes but steroids trigger high blood sugar. The fourth group is where the virus attacks the pancreas and causes high blood sugar levels. These patients usually need insulin,” Dr Joshi said.
He said he has seen a rise in the last two groups especially because of the indiscriminate use of steroids.
Use steroids only if needed
“In the past two weeks, there is a rapid rise in steroid-related diabetes in Covid-19 patients. We urge that steroids not be used in the first week when not needed. A recovery trial indicates mortality improvement with steroids when they are used with a mechanical ventilator or for those who need ventilator support with oxygen. Premature or early use of steroids can harm metabolic health,” said Dr Joshi.
Dr Om Shrivastav, infectious disease expert and another member of the state task force, said he has noticed a rise in stress-induced high blood sugar levels.
He said, “The patient may be having underlined diabetes or may be at a higher risk that gets unmasked when they get Covid-19. We are definitely seeing a significant rise in such cases, especially in borderline diabetic patients affected by steroids or stress.”
Though there are no studies to prove the connection, Dr Vasant Nagvekar, infectious disease expert, Global Hospitals, said, “We are seeing high blood sugar caused by both steroids and the virus. Stress is also playing a key role.” Dr Joshi said that recovered Covid-19 patients must follow a strict diet and monitor blood sugar for three months.
“One should not panic and stress after getting Covid-19 or being prescribed insulin. Intensive monitoring of blood sugar levels is most important,” said Dr Shehla Shaikh, endocrinologist, Saifee Hospital.
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No. of ways in which diabetes is hitting Covid-19 patients
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