Diabetes and Coronavirus FAQ: An Interview with Dr. Mariela Glandt

Diabetes and Coronavirus FAQ: An Interview with Dr. Mariela Glandt

Coronavirus (COVID-19) is spreading throughout the U.S. and the CDC has urged people with diabetes to stock up and be ready to stay home (if you aren’t there already). The best way to prevent coronavirus is to avoid being exposed. Social distancing is critical. So is washing your hands. 

Dr. Mariela Glandt
Dr. Mariela Glandt

We’ve come across many articles that say people with diabetes are at higher risk for severe coronavirus symptoms, and we know many of you are very concerned. We talked to Dr. Mariela Glandt, an endocrinologist who specializes in treating Type 2 diabetes with the keto diet, to get some more information for you. In this interview, she breaks down some of the things people with diabetes need to know about COVID-19.


Are people with diabetes more susceptible to coronavirus?

Our knowledge of coronavirus is still limited. What we do know is that hyperglycemia -especially blood sugar over 200mg/dL- impairs immune function. In addition, people with diabetes may be starting to fight the corona battle at a disadvantage, because they may have compromised endothelial function due to the damage that hyperglycemia and insulin resistance can cause over years.

There may be other reasons particular to this virus that make it more dangerous for people with diabetes, but we still have a great deal to learn about this.


Are people with diabetes at higher risk for severe coronavirus complications?

 It does appear that people with diabetes tend to have worse outcomes. The data from China  suggests diabetes may be a risk factor for lung complications. Virta Health  has noted that hyperglycemia at hospital admission was associated with a greater risk of lung injury, but does not appear to be associated with greater risk of death.


Do I need to stock up on insulin or other medications? 

It’s probably a good idea to have extra supplies at this time. You may need to do additional blood sugar checks to make sure you’re staying in range. And illness can cause insulin resistance, so you might need more insulin if you are sick. Aside from a physical illness, psychological stress can also make your glucose levels rise.

Do I think that we’re not going to have insulin or medications in the pharmacy and that we should stockpile large amounts? I am optimistic that we will not get to that point. But don’t take a chance on running out of your medication. Another thing is that you want to avoid going out now, so having supplies at home will enable you to make fewer trips to the pharmacy.


If I get coronavirus, what are the most important things for a person with diabetes to monitor?

Blood sugar. Be really vigilant. You want your immune system at full capacity. If you take an SGLT2, you should monitor ketones. And be sure to be in regular contact with your doctor.


Should I make any changes to my diet or medications during this period of uncertainty?

Don’t make any drastic dietary changes at this time by yourself. For example, starting a ketogenic diet in patients with diabetes often requires medication adjustments that should be done under a doctor’s guidance.


Is there any evidence that being in ketosis can help us prevent coronavirus infection, or lessen the severity of symptoms if we are infected?

No. There is no evidence that I know of. We know that keto reduces inflammation, which can have a positive effect on the body, but I haven’t seen sufficient data to say that the diet boosts immunity. If you know otherwise, please leave a comment.


What are your recommendations to people with diabetes during the coronavirus outbreak?

Maintaining normal blood sugar is critical right now because diabetes is associated with immune system dysfunction. If your blood sugar is high, your immune system is weakened.

Stay home. Take your medication. Get a good night’s sleep.  Do some kind of exercise every day.  Keep blood sugar normal! The truth is that everyone now, whether or not they have diabetes, should avoid buying junk food. Processed high carb and high sugar foods are toxic. If you don’t have them at home, you won’t struggle with the temptation to eat them. Since you’re not going out, you have no opportunities to eat junk food. You are fully in control of your environment now.

It’s a terrible time in the world, but we can also make it a reflective one. Have we humans been treating our bodies as well as we should? With a mere 12% of American adults in good metabolic health, I think we can safely conclude we haven’t been.  Have we doctors been treating our diabetes patients correctly? If they’re progressing to complications, rather than putting the disease into remission, I think the answer is no. We are very vulnerable to this virus now, and Type 2 diabetes is a risk factor for corona-related complications. We need to fuel ourselves with nourishing food. For everyone in the world, a commitment to healthy living has never been more critical.

Jessica Apple
Jessica Apple

Jessica Apple grew up in Houston. She studied Bible and Ancient Near Eastern Studies at the University of Michigan, and completed an MA in the same field at the Hebrew University. She began to write and publish short stories while a student, and continues to write essays and fiction while raising her three sons (and many pets). Jessica’s work has appeared in The New York Times Magazine, The Financial Times Magazine, The Southern Review, The Bellevue Literary Review, Tablet Magazine, and elsewhere. She is the diabetes correspondent for The Faster Times. In 2009 she and her husband, both type 1 diabetics, founded A Sweet Life, where she serves as editor-in-chief. Jessica loves spending time with her sons, cooking with her husband, playing with her cats, reading, biking, drinking coffee, and whenever possible, taking a nap. Follow Jessica on Twitter (@jessapple)

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