Worldwide cases of Covid-19 are declining. But Covid-19 is not over yet and as asserted by the WHO earlier this year, it “remains a dangerous infectious disease with the capacity to cause substantial damage to health and health systems”. The dominant SARS-CoV-2 strain continues to be the Omicron variant of concern, according to the latest edition of the WHO’s Weekly Epidemiological Update dated Feb. 15, 2023. Omicron BA.5 and its descendent lineages caused less than half (42.7%) of the cases globally with the BA.2 accounting for 13.1% cases. Recombinant variants have increased to ~33%, the most common being XBB.1.5. But the good thing is that these variants are mostly mild, though highly infectious and do not lead to much hospitalizations.  

Diabetics are at high risk of acquiring Covid-19 and they have also been reported to suffer adverse outcomes if infected by COVID-19. These adverse outcomes occur through an imbalance in angiotensin-converting enzyme 2 (ACE2) activation pathways leading to an inflammatory response. ACE2 imbalance in the pancreas causes acute β-cell dysfunction resulting in increased blood sugar levels. Diabetic individuals are also prone to other Covid-19 complications including vasculopathy, coagulopathy as well as psychological stress.

A spurt in cases was noted last year raising the possibility of a fourth wave, which was unconfirmed. Patients then presented mostly with stomach-related health issues such as diarrhea, bloating, etc.

Fever and fatigue may be initial symptoms and may be associated with difficulty in swallowing or sore throat. Patients may have persistent cough for many days, which is usually dry and only mildly productive. The persistent cough may lead to scratchy throat or chest pain.

Bodyache or mild muscular pain may be the most common symptom of COVID-19 in diabetics, although it is common in non-diabetics too. Nausea or vomiting were new symptoms and abdominal upset may be the only symptom in patients with diabetes.

Warning signs include difficulty in breathing, dip in oxygen saturation, chest pain, confusion, change in skin color and dehydration.

People with diabetes should take all doses of Covid-19 vaccine as advised. They should also avoid public places, crowded areas, wear masks and follow all recommended Covid-appropriate behaviors.

In densely populated countries such as India, living with the virus is possible only when most people have good protection against it through previous infection or vaccination.

Diabetics should regularly monitor their blood glucose levels and other comorbidities. They should take their prescribed anti-diabetic medicines or insulin regularly and follow a healthy diet and do exercise daily.