April 9, 2020
COVID-19: perspectives from people with diabetes
The pandemic and the restrictions put in place to tackle it are impacting the daily lives of people with diabetes around the world in many ways.
The COVID-19 pandemic is impacting almost every country in the world. The latest figures indicate that over 1.4 million people have contracted the virus. In response to the pandemic, governments in many countries have restricted the movement of their citizens, confining them to the home environment and disrupting the daily lives of billions of people. People with chronic conditions like diabetes appear to be more vulnerable to the severe effects of the virus.
We asked people with diabetes from all corners of the globe, members of the IDF Blue Circle Voices and Young Leaders in Diabetes networks, to share their testimonies of how COVID-19 has impacted their daily lives. How have they coped with the restrictions that have been put in place? What have they done differently to stay healthy and safe and manage their condition effectively? Do they feel their government has done enough to help people with diabetes?
Lucas Xavier de Oliveira (Brazil) I’m very afraid of being infected, knowing that it can lead to devastating consequences. However, I try to maintain my physical and mental health in the best way possible and follow the guidelines of international and local health organisations.
Nupur Lalvani (India) COVID-19 has affected me on many different levels. One of the most urgent issues has been the lack of easy availability of medical supplies due to transportation and courier services no longer operating. As a result of the strict lockdown measures, my exercise schedule has been completely changed. I can’t go out for a run or go to my Mixed Martial Arts class, so I try to motivate myself for a home workout regime, which I find boring. There is a dark cloud of anxiety looming over everyone and that sometimes affects me too.
Sara Abbasian (Iran) When everything started I was really scared, not only for my own health but also that of my family. However, after two or three weeks during which I became more informed and consulted my doctor, I eventually volunteered as a nurse in the Acute Respiratory Disease Unit at Shariati hospital. I test my blood glucose more frequently (6 to 10 times a day) for any fluctuations and wash my hands more regularly. I also try to stick to a plan of drinking water every 2 hours to stay hydrated. My mother continues to cook healthy meals to keep my immune system strong. COVID-19 has had some positive effects, reminding me to be more sensible about my lifestyle and making me more alert towards my family and patients.
COVID-19 has made me very anxious, fearful and afraid because every information source seems to make reference to the fact that people with underlying conditions, including diabetes, are more prone to the severe effects of the virus. (Heather, Zimbabwe)
Alessio Liguori (Italy) COVID-19 has changed my life. Since March 10, which happened to be my birthday, we have been ordered by the government to stay home, only allowed out to go to work, the hospital, the pharmacy and shopping at the supermarket. The restrictions have prevented me from training as I always do, but I still train at home every other day. The more regular lifestyle has improved my blood glucose levels and, thanks to regular monitoring, I have not experienced serious highs or lows. Staying at home has also made it much easier to respect all meal times.
Jeena Kim (Korea) As a person living with diabetes, my focus is on managing my blood glucose more than usual. In February, I consulted my endocrinologist who stressed that the best way for people with diabetes to increase immunity to viral infection is to control their blood glucose. People with diabetes can be exposed to the virus just like anyone else, but I believe we won’t be affected any differently if we keep a handle on our blood glucose.
Gerard Rovira (Spain) As a healthcare professional and person with type 1 diabetes, I’m concerned about my personal health and that of my patients. I try to follow all the recommendations from WHO but I’m more worried about the health of children and the elderly and how the millions of people forced to stay at home will be impacted. At the moment, we don’t know the effects that the imposed confinement will have on our own bodies and those of our families. Children and the elderly need to be in constant motion and movement. For people with diabetes like myself, as long as we manage our condition well and are not at risk of cardiovascular or other complications, we can thrive in a pandemic situation like the current one.
Heather Koga (Zimbabwe) COVID-19 has made me very anxious, fearful and afraid because every information source seems to make reference to the fact that people with underlying conditions, including diabetes, are more prone to the severe effects of the virus. This constant reminder has made me panic. However, on a more positive note, the messaging has also made me more motivated to take better care of myself as a person living with type 2 diabetes.
Sara Abbasian (Iran) From the information I’ve gathered on the topic, I’ve learnt that as long as people with diabetes keep their blood glucose in control, they’re at no greater risk than other people. So the general recommendations such as washing hands, eating healthy meals or standing 1.5 meters apart are enough. I do get a flu vaccination every year which other people may not do.
Alessio Liguori (Italy) In Italy, everyone has understood the seriousness of the situation and are taking the maximum safety measures. In my family, only my parents go out to work, always wearing a mask and protective gloves. When they come back from grocery shopping, we disinfect everything they bought and leave the shoes and clothes they wore outside the door and wash them, before anyone else in the family can touch them. What I’m perhaps doing more than the others is following a diet rich in vitamin C and Omega 3, to strengthen my immune system.
Weronika Burkot (Poland) The first thing I made sure of was that I had all the medicines and supplies that I needed for at least 2-3 months. I self-isolated and reduced my interaction with other people to the bare minimum. My husband is doing the grocery shopping every 2 weeks and picking up any deliveries we get. We are disinfecting all the groceries and packages. When we go out for a walk or a run, we pick times when there is almost no one around and avoid open spaces like parks.
I've learnt that as long as people with diabetes keep their blood glucose in control, they're at no greater risk than other people. (Sara, Iran)
Gerard Rovira (Spain) I try to reduce my own risk of infection by following all the personal hygiene recommendations that we receive from the health authorities, taking vitamin supplements, drinking plenty of water, eating healthily, exercising at home and getting a good night’s sleep.
Heather Koga (Zimbabwe) I’ve made sure to be more cautious when it comes to personal hygiene and physical distancing, compared to other people around me. I notice some people taking a more relaxed approach, and have had to remind myself that they may have a better chance of survival if they catch the virus, compared to me. I’m taking my medicines and exercising religiously and also taking vitamin supplements to boost my immunity.
Liliana Tieri (Argentina) In Argentina, the government has learned a lot from the experiences of other countries in regards to COVID-19. The measures it has implemented have been very good in terms of ensuring physical distancing and making it possible to conduct doctors’ consultations and purchase medicines online. However, for people with diabetes I think that many long-standing issues have not been taken into account, and have been made much more visible due to the current crisis.
Dimitris Kaperdanakis (Greece) In Greece, the authorities took immediate action and were not hesitant in applying physical distancing policies at an early stage. However, when it comes to high risk groups and particularly people with diabetes, precautionary assistance has been limited. Until now, people with diabetes who work for the public sector and the state cannot work from home unless their diabetes is uncontrolled. This policy was introduced without any additional information or explanation of how poorly managed diabetes could be proven to HR departments. This distinction of “controlled” and “uncontrolled” people with diabetes has led to misinformation and unequal treatment of those in specific need of protection.
Nupur Lalvani (India) The Indian government, like most governments around the world, is focused on understanding and containing the pandemic. I don’t think they currently have the bandwidth to give special consideration to the needs of people with diabetes.
Tannaz Almirhosseini (Iran) Like in many other countries, the government was taken by surprise by COVID-19. Availability of insulin around the country is low. I can’t buy diabetes supplies near my home and the few pharmacies that provide them are really crowded every day. The hospitals are also overcrowded. Friends with diabetes that experienced DKA and severe hypos did not want to be admitted to hospital for fear of catching the virus. People with type 1 diabetes are helping each other out by sending insulin, test strips and other supplies to those in need. This is a tough situation for many of us and I am worried for people that can’t afford their medication.
Alessio Ligouri (Italy) I think my government has done a lot to protect people with diabetes and the general population. Remote working has been introduced for all non-essential work that can also be done from home; people who have been made unemployed receive benefit that equals 80% of their previous salary; and workers with children with disabilities have been granted 14 days of paid leave. Hospitals and health professionals have also made important contributions: day hospitals are held online and remain accessible for emergencies; professional diabetes associations (such as SID, AMD and SIEDP) have started online courses on Facebook; and my own association (A.N.I.A.D.) has created a protocol for physical activity in the home environment.
People with type 1 diabetes are helping each other out by sending insulin, test strips and other supplies to those in need. (Tannaz, Iran)
Jeena Kim (Korea) Our government has done an excellent job in delivering the important and relevant messages for people with diabetes. Since the start of the pandemic, I have seen news broadcasts advise people with diabetes to pay extra attention to the management of their condition. Other government entities are also using the media to raise public awareness. The National Health Insurance Service recognized the seriousness of the current situation and announced special measures allowing people with chronic conditions to obtain necessary supplies without needing a prescription.
Gerard Rovira (Spain) I did not receive any extra consideration as a person with type 1 diabetes. My thoughts go to our public health system, which is facing a very challenging time. Health workers have been on the front line since the beginning, exposed to COVID-19 in large numbers. So if our healthcare providers are unprotected due to lack of resources, imagine a small group like people with type 1 diabetes or other groups at higher risk, like the elderly. They have not received any extra consideration or guidelines to follow.
Heather Koga (Zimbabwe) My government has not taken into account the needs of people living with diabetes, or any other group particularly vulnerable to the effects of COVID-19. They have done nothing to improve access and affordability of medicines for people living with diabetes. A 21-day national lockdown starting on March 30 was announced less than three days earlier. This did not give people with diabetes enough time to stock enough medicines in preparation for the lockdown. High prices, panic purchases and supply inconsistencies made it impossible for some people with diabetes to get the medicines they needed. This was particularly an issue in remote locations where people have to travel long distances to access medical supplies. It would have been better if the government had ensured adequate stocks of medicines for people with diabetes and provided subsidies for these medications so that they were more affordable to those who need them.
Gerard, Heather, Liliana, Nupur, Sara and Weronika are members of the IDF Blue Circle Voices network. Learn more about them.
Alessio, Dimitris, Jeena, Lucas, Tannaz and Weronika are members of the IDF Young Leaders in Diabetes network. Learn more about them.