Diabetes and the COVID-19 Pandemic: More Than Ever, it’s Important To Take Care of Your Health

Even before the COVID-19 pandemic, diabetes was a major health concern in the United States.

In early 2020, the Centers for Disease Control and Prevention (CDC) estimated that over 37 million people in the U.S. had diabetes, and one in five of those with diabetes didn’t know it. The CDC also estimated that 96 million adults in the U.S. had prediabetes, and eight in 10 with it were unaware.

Concerns have only grown in the past two years. More than 87,000 people died from diabetes in 2019, according to the CDC. In both 2020 and 2021, diabetes caused the deaths of more than 100,000 people.

Now, more than two years into the pandemic, we know that patients with prediabetes or diabetes are at a higher risk for complications from COVID-19 – including a higher risk of death. That’s why understanding diabetes and caring for your own health are important. 

Understanding and Diagnosing Diabetes

Diabetes is a condition that affects how your body turns food into energy.

In type 1 diabetes, your body quits making a hormone called insulin, which helps deliver sugars to your muscles and other organs to be converted to energy.

Type 2 diabetes is a condition where your body makes insulin but doesn’t respond to it the way it should.

Diabetes can be diagnosed based on various criteria, including:

1. Fasting blood sugar. A result of greater than or equal to 126 mg/dl indicates diabetes, and a result between 100 and 125 mg/dl indicates prediabetes.
2. An oral glucose tolerance test. With this test, a doctor gauges how your body processes sugar by checking your blood sugar before and after you drink a sweet beverage. Diabetes is diagnosed if your blood sugar is 200 mg/dl or greater two hours after drinking the beverage. A result of 140-199 mg/dl indicates prediabetes.
3. A random plasma glucose test. Diabetes is diagnosed if this blood test yields a result of 200 mg/dl or more and you have hyperglycemia symptoms, which include increased thirst and increased frequency of urination.
4. An A1C blood test. This test measures your average blood sugar level over the past three months. A result of 6.5% or more indicates diabetes, while a results of 5.7% to 6.4% indicates prediabetes.

Diagnosing Type 1 Diabetes

When diagnosing type 1 diabetes, the same guidelines outlined above apply. However, your provider should check your C-peptide level. C-peptide is a protein that is used to make insulin by your pancreas. If your C-peptide level is less than 1.0, your pancreas may not be making enough insulin.

In type 2 diabetes, your pancreas can wear out from trying to manage a large amount of carbohydrates, but it can recover and make insulin again once the diabetes is under control. In type 1 diabetes, blood tests can detect that certain immune cells in the body are attacking the pancreas’ insulin production. If you’re diagnosed with type 2 diabetes and your sugars aren’t improving with medication and dietary and lifestyle changes, you should be screened for type 1 diabetes. 

What Is Prediabetes?

Before people develop type 2 diabetes, most have prediabetes – a condition in which blood sugar levels are higher than normal but not yet high enough to be diagnosed as diabetes. 

Doctors sometimes refer to prediabetes as impaired glucose tolerance. In this stage, your pancreas is working hard to make insulin. If your diet is high in unhealthy carbohydrates (what the body sees as sugar), your pancreas starts to get tired and can’t keep up with the demands. 

You can think of insulin as unlocking doors that allow sugars to go from the bloodstream into the muscles, liver and fat tissue. Many patients with prediabetes develop insulin resistance – in other words, the doors are not opening as well. As a result of the sugar remaining in the blood, the pancreas continues to pump out even more insulin. Eventually, the pancreas’ ability to produce enough insulin can decline, resulting in higher glucose levels in the blood in the range of diabetes. 

Excess insulin can also lead to:

• Acanthosis nigricans – a leathery darkening of the skin, typically on the neck, armpits or groin area
• Fatigue
• Fatty liver disease
• Skin tags
• Weight gain or difficulty losing weight

Risk Factors

Risk factors for prediabetes and diabetes include:

• Being age 45 or older
• Being overweight
• Having a parent or sibling with type 2 diabetes
• History of gestational diabetes (diabetes during pregnancy) or giving birth to a baby who weighed more than 9 pounds
• Limited physical activity – less than three days a week of moderate exercise
• Polycystic ovary syndrome

Certain people are also at higher risk for prediabetes – those who are African American, Hispanic/Latino American, American Indian or Pacific Islander, and some Asian Americans.

Preventing Type 2 Diabetes

You won’t automatically develop type 2 diabetes if you have prediabetes. For some people with prediabetes, early treatment, changes in lifestyle and dietary changes can return blood sugar levels to the normal range. Research shows that you can significantly lower your risk of type 2 diabetes by:

Losing 7% of your body weight. Diets shown to help with this include the Mediterranean diet and the DASH diet. General dietary behavior changes can also help. For example, use the plate method to control portions of what you eat.

Exercise moderately. Take part in an activity like brisk walking for 30 minutes a day, five days a week. In general, 150-300 minutes of light to moderate exercise is recommended every week. While the COVID-19 pandemic disrupted and canceled gym routines for many people, remember that there are plenty of ways to stay active at home.

Diabetes Complications

People with type 2 diabetes are at risk for health issues that include:

• Depression
• Erectile dysfunction in men
• Eye damage or blindness
• Gastroparesis – damage to your stomach and the way it empties
• Heart attack
• Kidney damage or failure
• Loss of toes, feet or legs
• Nerve damage
• Stroke

Unfortunately, thousands of people in the U.S. die each year from diabetes complications. In fact, the risk of early death for adults with diabetes is 60% higher than for those without diabetes.

Managing Diabetes

There is no known cure for type 2 diabetes, but it can be managed – and it’s critical that you do so. A recent study from the American Diabetes Association showed that with appropriate lifestyle and dietary changes, type 2 diabetes can go into remission (but won’t be cured).

Many diabetes management plans involve:

• A healthy diet
• An active lifestyle
• Education and support
• Healthy weight loss and maintenance
• Preparation for diabetes care during emergencies
• Proper blood sugar monitoring and management

Whatever your plan, it should involve your health care team and its recommendations. Some people can effectively manage their diabetes with the help of their primary care provider, while others may need additional support.

Finding Support

At Methodist, we offer a range of solutions to help people with diabetes achieve their goals. Our staff includes diabetes and endocrinology specialists, health coaches, dietitians and care navigators who are committed to helping you succeed. We also offer several classes and programs tailored to your situation.

While diabetes may be part of your life, it doesn’t have to define it. With the right plan and support system in place, you can take control of your diabetes and thrive.