LETTER | Diabetes and Covid-19

LETTER | World Diabetes Day is celebrated annually on Nov 14 to raise awareness about the growing health threat posed by diabetes.

In the 2019 National Health and Morbidity Survey, 50.1 percent of Malaysian adults were found to be overweight (30.4 percent) or obese (19.7 percent). This predominantly lifestyle risk factor can partly explain the increasing diabetes prevalence in Malaysia. In 2019, a staggering 3.9 million Malaysian adults had diabetes.

People with diabetes suffer another blow during this Covid-19 pandemic. If infected, they are 2.4 times more likely to suffer severe Covid-19 and their mortality risk is 2.5 times more than those without diabetes. From the Covid-19 statistics in Malaysia, 70 percent of those who died had underlying diabetes comorbidity.

Evidence also shows that poor glycated haemoglobin A1C (blood sugar control over two to three months) is an independent predictor for Covid-19 deaths. In England, patients with poor A1C were up to 60 percent more likely to die from Covid-19 than those with optimal A1C control.

The diabetes management guidelines before and during this pandemic have recommended optimal control of A1C, blood pressure, and LDL-cholesterol (bad cholesterol) – also known as the “ABC” of diabetes.

The benefits of achieving more ABC treatment goals are incremental. The more goals achieved, the better the outcomes in preventing diabetes complications such as kidney disease, heart attack, and death. Diabetes patients with better A1C control are shown to have better Covid-19 outcomes.

However, data from the pre-Covid-19 era showed that the proportion of patients achieving all ABC goals were under 10 percent in most parts of the world. In Malaysia, only 5.8 percent of our diabetes patients attained all their ABC goals.

What can Malaysian adults with diabetes do?

1. Be aware of the importance of ABC control. Know your ABC values, monitor them, and try to achieve your treatment goals.

2. Adhere to your treatment plan. If your doctor thinks there is a need to modify current therapy, be more receptive to it.

3. Eat sensibly, exercise regularly, reduce bodyweight (if overweight/obese), and stop smoking.

4. Practice diabetes self-care such as monitoring blood sugar at home and checking your feet regularly.

5. Adhere to your medical appointments during this pandemic.

6. Exercise preventive measures such as washing hands frequently, wearing masks correctly, practising physical distancing, and following Covid-19 Standard Operating Procedures (SOPs).

The theme for World Diabetes Day 2020 is ‘The Nurse and Diabetes.’ The campaign aims to raise awareness around the crucial role that nurses play in supporting people living with diabetes.