• Lellieth Keize

Diabetes Management during COVID-19 and Beyond

It is a well-known fact that managing diabetes is one of the most difficult feats for someone with the disease. Having this chronic disease can be life-changing because it means making changes to the daily routine of life. The added responsibilities of taking medication, checking blood glucose, eating certain foods, monitoring portions, avoiding sugar-sweetened beverages, and restricting alcohol can be emotionally draining and may result in anxiety, sadness, depression, and in some cases eating disorder.


Since the COVID-19 pandemic, family members, friends, and patients reported that they feel anxious and fearful that they might get the virus. Some reported that they are having a hard time maintaining good blood sugar levels. The recommendations given by the Centers for Disease Prevention and Control to the general population to reduce the risk of COVID-19 includes practicing social distance, washing hands regularly, and wearing a mask. For individuals with diabetes, other steps need to be taken to reduce the risk of this virus.


Listed below are seven self-care behaviors recommended by the Association of Diabetes Care and Education Specialists to help individuals manage their diabetes. These behaviors can be utilized long after this pandemic is over, visit AADE7 Self-Care Behaviors for Managing Diabetes Effectively for more comprehensive information.

Healthy Eating

Food has a major effect on your blood sugar and your weight. Carbohydrates (Carbs) such as starches (bread, rice, pasta, etc), dairy, fruits, and starchy vegetables (corn, peas, beans potatoes, etc) have the greatest effect on blood sugar. Lowering the intake of these foods by using the Plate Method as a guide to monitor your portions can be helpful. The Plate Method guide is a great way to manage your weight along with your blood sugar. It include making 1/2 of your plate vegetables/fruits, 1/4 protein and 1/4 starch. For more information on the Plate Method visit https://www.choosemyplate.gov/


Being Active

Exercising for at least 30 minutes 5 days per week or 10 minutes after each meal can help to lower your blood sugar. Walking is one of the most basic form of exercise-no equipment needed. This can be done inside your home, no need to go outside at this time. Start slow with 5-10 minutes at a time then increase to 30 minutes. Visit https://glucosezone.com/home for a specialized exercise program. For those with limited mobility, chair exercises can be done to become active. Seniors can visit https://www.silversneakers.com/ for online exercise classes and workout videos.


Monitoring Blood Sugar

When you monitor your blood sugar you get to see how different foods, your medication, illness, and exercise affect your blood glucose. Monitoring helps you to also know when blood glucose is outside of the recommended range and enables you to take the necessary actions for correction. Self-monitoring usually depends on the diabetes goal you set with your diabetes care and education specialist or healthcare provider.


Taking medication

Taking your medication is one of the most important aspects of diabetes management. I cannot count the number of times when I was working as Clinical Dietitian in the hospital when patients would be admitted with hyperosmolar hyperglycemic state (severe high blood sugar). One of the main reasons was that they did not take their diabetes medication for weeks or for a few days. Along with diet and exercise, taking your medication helps to lower your A1C, reduce your blood sugar level, and reduces your risk of health complications.


Problem Solving

Diabetes management also involves problem-solving skills. You need to plan ahead and also have solutions to some problems that might occur in your life. For example, before you go to a restaurant it might be best to check out their menu to see what you can order to eat. If you are on mealtime insulin take it with you to the restaurant because you do not know what time the meal will be served. Have a sick-day plan and be prepared to know how to implement it. Please visit https://www.diabetes.org/diabetes/treatment-care/planning-sick-days for more information.


Reducing Risk

Diabetes management is incredibly important as the disease puts you at risk for other health complications including COVID-19. You can reduce your risk of this disease by following up with your healthcare provider (HCP) at least every 3 months. Know your numbers- A1C, blood pressure, and cholesterol. Learn more about managing your diabetes by attending a diabetes education program. Check your feet daily, do all the healthy examinations recommended by your physician. Take your medication, eat healthily, exercise, and maintain the recommended blood glucose level. Avoid smoking and see a mental health specialist if you are feeling depressed, stress, or anxious about COVID-19 or any other issues in your personal life.


Healthy Coping

My mother would sometimes say to me "I am just tired of injecting myself." I would reassure her that it is for her own good and explain to her the disadvantage of not taking her insulin. This disease affects you mentally, emotionally, and physically. Most times when I talk to my relative with diabetes they would tell me that they feel so much better talking with me or friends who also have the disease. Join a diabetes support group, talk to your HCP about managing stress, seek out friends, family, and your church support system to talk about the feelings you might have about your diabetes. Think positive! Diabetes management is aided by healthy coping. For more information on healthy coping visit https://www.diabeteseducator.org/living-with-diabetes/aade7-self-care-behaviors/healthy-coping and to connect with a support group visit, https://dlife.com/diabetes-blog/connect-with-a-diabetes-support-group/.


Bottom line

Poorly managed diabetes can lead to numerous health complications including severe outcomes if infected with COVID-19. With the plan to re-open the country, individuals with diabetes must take extra precaution to prevent the infection. If you have long standing diabetes ask your HCP to refer you to a diabetes program in your area or speak to a diabetes care and education specialist.


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