Covid-19 & Diabetes- effective ways of management

Covid-19 has been proved the destructive and deadly virus impacting many people globally. Reports from major Covid-19 centres have revealed the morbidity and mortality is more among patients with history of diabetes, hypertension, obesity, kidney or heart condition. Diabetic patients appear to be more vulnerable of becoming severely ill with Covid-19. Prescribed medicines can be bought from online pharmacy app Delhi.

When people with diabetes develop a virus infection, it is harder to treat because of fluctuations in blood sugar levels and, possibly, the presence of diabetes complications.There appear to be two reasons for this.
Firstly, the system is compromised, making it harder to fight the virus and certain resulting in a extended recovery period.

Secondly, the virus may thrive in an environment of elevated blood sugar. consistent with a study published in lancet journal, Data from two hospitals in Wuhan including 1561 patients with COVID-19 showed that those with diabetes (9·8%) were more likely to need admission to an medical care unit (ICU) or to die.

PROGNOSTIC FACTORS
Age is related to worse outcomes in COVID-19, and it is hypothesised that this relationship is stronger in people with diabetes for a minimum of three reasons.
First, the prevalence of diabetes increases with age to succeed in a peak in people older than 65 years.
Second, people older than 65 years are more likely to possess  diabetes and a greater prevalence of diabetic complications.
Third, diabetes and older age often correlate with comorbidities like disorder, hypertension, and obesity.

TREATMENT
Patients admitted to hospital for severe COVID-19 might need modifications to their diabetes therapy, including withdrawing ongoing treatments and initiating insulin therapy. Such a choice should support the severity of COVID-19, nutritional status, actual glycaemic control, risk of hypoglycaemia, renal function, and drug interactions.
Treatment with chloroquine or hydroxychloroquine can cause hypoglycaemia, particularly in patients on insulin or sulfonylureas, due to their effects on insulin secretion, degradation, and action.

Let us learn about some advantages of Interaction of anti- diabetic drugs with Covid-19 drugs:

Metformin +Lopinavir-  No risk of hypoglycemia
DPP-4 Inhibitors  + Lopinavir/Ritonavir  - No risk of hypoglycemia. Potential modification of SARS-CoV-2 binding to DPP-4 inhibitors
SGLT2-inhibitors + Rotinavir -No risk of hypoglycemia 
GLP-1 receptor agonists + Atazanavir-     Potential anti-inflammatory action.

You can buy medication online. Usual reception antidiabetic therapy is maintained in patients receiving treatment in hospital with regular caloric and fluid intake consistent with the clinical status, risk of drug-related adverse effects, and interactions between antidiabetic agents and medicines used for the treatment of COVID-19.

However, insulin is that the preferred agent for glycaemic control in patients with diabetes receiving treatment in hospital, and its use is mandatory in critically ill patients.

Conclusion
The inter-relationship between diabetes and COVID-19 should trigger more research to know the extent to which specific mechanisms of the virus (eg, its tropism for the pancreatic β-cell) might contribute to worsening of glycaemic control once more, diabetes management in patients with COVID-19 poses an excellent clinical challenge, one that needs a much-integrated team approach, as this is often an important strategy to scale back the danger of medical complications and death.