Ongoing Coronavirus Pandemic Has Worsened Existing Challenges Facing Indian Diabetics

The ongoing coronavirus pandemic has led to insurmountable hurdles in the treatment of other diseases throughout the world. Diabetes presents comorbidity risks to those infected with COVID-19, and threats posed by the disease have worsened drastically during the pandemic. In India, 73 percent of the COVID-19 fatalities are associated with comorbidities including diabetes, hypertension, as well as cardiovascular and respiratory diseases. With over 77 million diabetes sufferers, India has been dubbed the diabetes capital of the world.

In a first-of-its-kind study, conducted by researchers from the National Diabetes, Obesity and Cholesterol Foundation, the Diabetes Foundation (India), Fortis CDoc, and Dr. Mohan’s Diabetes Specialities Centre, in ‘Diabetes & Metabolic Syndrome: Clinical Research & Reviews', it was found that the "onset of diabetes during the pandemic in India is far worse than the diagnosis in pre-covid times".

Since the beginning of the pandemic, diabetes mellitus has "emerged as one of the distinctive comorbidities that have consistently been associated with severe disease, acute respiratory distress syndrome, and mortality in COVID-19".

"With the entire world’s healthcare workforce focusing on COVID-19, attention towards patients dealing with chronic conditions was fairly limited. Patients started looking out for digitally enabled solutions that can help provide personalised and on-demand care, with real-time monitoring and improved patient-platform engagement at affordable prices," Rohan Verma, Co-founder and CEO of Breathe Well-being told Sputnik.

Verma also said that if an individual suffering from diabetes contracts COVID-19, his condition is much more severe and the viral infection progresses more quickly.

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During the second wave of the coronavirus pandemic in India, the challenges and struggles of patients with diabetes increased manifold. According to a study by the Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, and other Indian institutes, routine diabetes care was compromised which led to "suboptimal glycemic control" that was also seen during the lockdown during the first wave of the pandemic.

"Covid-19 has made the lives of people with diabetes very difficult. One is a higher risk of severe disease and mortality. Second, access to healthcare itself, third, lack of exercise due to work-from-home culture. All these factors have led to worsening sugar control in people with diabetes. On top of this, there is a large set of people who have developed diabetes post-Covid and also due to steroids which they received during treatment of Covid," Dr. Arbinder Singal, Co-founder & CEO, Fitterfly told Sputnik.

Studies also suggest that Type 2 diabetes (T2D) patients who had COVID-19 showed significantly more fatigue when compared with patients who did not have COVID-19, and it complicates the recovery of COVID-19 patients.

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According to the World Health Organisation (WHO), over the past three decades, the prevalence of type 2 diabetes has risen dramatically in countries of all income levels. Although a target has been set to "halt" increasing cases of diabetes and obesity by 2025, people with diabetes are still struggling with basic and affordable treatment including access to insulin which is extremely important for their survival.

What is Diabetes?

Diabetes is a disease that occurs when blood glucose, also known as blood sugar, is extremely high. Although there are several types of the "sugar disease", Diabetes Type 2 is considered the most common globally. According to the WHO, more than 95% of people with diabetes have type 2 diabetes and it is largely caused by excess body weight and physical inactivity. Type 2 is now increasingly occurring in children, according to the WHO.

'Insulin Is Still A Luxury For Many Diabetics'

On Friday, the UN health agency announced that even a century after its discovery, insulin is still inaccessible to many diabetics across the globe.

"The scientists who discovered insulin 100 years ago refused to profit from their discovery and sold the patent for just one dollar. Unfortunately, that gesture of solidarity has been overtaken by a multi-billion-dollar business that has created vast access gaps," said Tedros Adhanom Ghebreyesus, WHO Director-General.

The WHO also pointed out that the global market has moved to pricier synthetic insulins from human insulin, which can be produced at a relatively low cost.

"High prices, the low availability of human insulin, a market dominated by just a few producers, and weak health systems have all created barriers to accessing the lifesaving medicine," the report said.

Insulin is extremely important to lessen the impact of the disease, and it also reduces the risk of kidney failure, blindness, and limb amputation for over 60 million patients living with diabetes type 2.

According to the WHO, over 420 million people throughout the world are living with diabetes, and most of them are from low-and middle-income countries. Meanwhile, 1.5 million deaths are directly attributed to diabetes each year, according to WHO data.

'Diabetes Emerging as a Post-COVID Symptom in Many Cases'

Diabetes occurs when the pancreas is unable to produce insulin or the body is not able to use the produced insulin adequately. As COVID-19 infections affect the pancreas too, it has also been linked to the onset of diabetes in many patients. Earlier this year, the Journal of Diabetes, Obesity, and Metabolism published a report that revealed that 14.46 percent of the hospitalised COVID-19 patients have returned home with diabetes globally. Several other global studies also claimed that COVID-19 has fuelled the diabetes crisis.

"The patients who already had uncontrolled diabetes succumbed to the deadly virus. Most diabetic patients didn't regularly visit their health care providers with the fear of contracting the virus at health care facilities hence ending up having uncontrolled diabetes," Dr. Haroon H, Consultant Internal Medicine, KMC Hospital, Mangalore told Sputnik.

People living with diabetes are susceptible to other health ailments which put their lives at an increased risk. During the second wave of the coronavirus pandemic in India, there was a rise in cases of mucormycosis (black fungus) as a post-COVID complication, especially among diabetic patients. Many of them were left without eyes or a nose and some died due to the rare anomaly.

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Several doctors told Sputnik that many diabetes sufferers in India are unaware that they have diabetes, which delays their treatment and worsens the condition.

"Right now due to decreasing Covid numbers diagnosis and treatment of diabetes is possible like earlier. There is a little rise in Diabetes cases in all places. CovidDiab registry is started for the same. With SARSCOV1 (SARS) also new-onset diabetes was seen, which lasted around three years. With SARSCOV2/COVID-induced diabetes, we need more studies to get into numbers and newer mechanisms. India is considered the Diabetes capital, and we strive to be the Diabetes Care capital of the world," Dr. Altamash Shaikh, Consultant Diabetologist, Wockhardt Hospital, Mumbai Central told Sputnik.

Dr. Haroon maintained that diabetic patients must focus on overall health as keeping diabetes under control is the key to preventing other complications, including infectious diseases. The doctors fear diabetes could become a bigger public health concern if neglected.