The impact of COVID-19 across the world continues to grow with over 5.7 million cases and more than 356,000 deaths recorded as of May 28. As previously reported in Diabetes Voice, people living with chronic conditions like diabetes have been more vulnerable to the severe effects of the virus. Studies have shown that, depending on the global region, 20 to 50% of people diagnosed with COVID-19 had diabetes and the risk of death from the virus was found to be up to 50 per cent higher in people with diabetes, particularly older people with type 2 diabetes. These stark figures have emphasised the importance for people with diabetes to maintain their blood glucose levels at the recommended levels through medication, diet and physical activity.
In April, when the pandemic and restrictive measures put in place by Governments to curb its impact were at their peak in many countries, we asked people with diabetes to share their testimonies of how COVID-19 was affecting their daily lives. One month later and with many national authorities having partially lifted or reduced the precautionary restrictions, we followed-up with people living with or caring for people with diabetes in Europe, North America and the Middle-East to see how they were adapting to the changing circumstances.
How has the COVID-19 pandemic impacted your diabetes care, treatment, mental health and general well-being?
Ehab Ali, living with type 1 diabetes, Bahrain: As a person with diabetes, I’ve been trying to control the main two factors which affect my condition: food intake and physical activity. I believe that as long as I keep these under control, I will be healthy. The main impact has been on my social life, particularly during the Holy Month of Ramadan, which not only involves prayer and fasting, but also communal gathering and celebration. This is something that I have missed because of COVID-19.
Francesca Ulivi, living with type 1 diabetes, Italy: COVID-19 has impacted what I do daily as general manager of a foundation that funds research for a cure for type 1 diabetes, and also member of an organization that tackles fake news and promotes science. The start of the pandemic here in Italy brought with it a kind of “infodemic”. Media were writing about everything and the opposite of everything and there was a lot of fake news around COVID-19. My daily work changed drastically and I spent a lot of time tackling the misinformation that was out there and informing the community correctly. There was more fake news every day that made many people, particularly those living with diabetes, very afraid of the virus.
Patricia Gómez Medel, carer of a person with type 1 diabetes, Mexico: When the whole COVID-19 situation began, my daughter Fer and I had some concerns which we discussed with our doctor. He explained that, like with other illnesses, Fer should play close attention to her blood glucose levels, continue with regular monitoring, watch her diet and do physical activity. So we continued to do everything as usual. The more information we have about diabetes, the easier it is to stay calm. This has been very important during the whole situation.
Have you adopted any new healthy habit during the pandemic?
Ehab Ali: Before the pandemic, I used to hang out a lot with my friends, trying different types of restaurants and foods. This was reduced to a minimum when the pandemic and lockdown started as I’ve had to eat most of my meals at home. I also started exercising at home and following simple and healthy tips, such as using the stairs instead of the elevator and walking small distances instead of using the car. These changes have resulted in improved body weight and better diabetes control.
Patricia Gómez Medel: We are aware of what we are going through. We are following all the recommendations issued by the health authorities. Fer does extracurricular activities to stay busy. She is improving her French by listening to music and watching French movies. Technology is helping us very much. Young people like Fer have access to so much information that they can learn from. She is also learning to cook at home. We remain calm, stay informed and, if we have any doubts, we look for a solution and talk to our doctor.
Have you been able to access support and medication when you needed it?
Ehab Ali: I’m so happy to have such a supportive and friendly healthcare team. They have been working around the clock to provide support and have organised many workshops and lectures on diabetes management, which answer my questions before I can ask them.
Francesca Ulivi: I’ve personally not had problems accessing the insulin and other medications and supplies I need to manage my diabetes. Other people with diabetes have had issues. When the lockdown started, many residents from other Italian regions were forced to stay in the location that they found themselves in at that time. In Italy, the health system is regional, which means that you can only freely access your medications and supplies in your region of residence. If you are in another region, for work or study for example, you do not have free access. As a community, we organised to give people with diabetes who found themselves in this situation the supplies they needed to manage their condition. This resulted in a sort of “kindness pandemic” of people helping one another.
Dr. Gilberto Mauricio, Fer’s diabetologist: People with diabetes who receive care from public health services have not had issues accessing their medication. In the private sector, where people with diabetes have to purchase their medicines, there has been some anxiety which has to led to panic-buying of insulin, test strips and other supplies, particularly from parents of children with diabetes who have been living with the condition for a short time.
How do you feel you can be better protected from COVID-19?
Ehab Ali: I have always believed that a person with diabetes is like anyone else. They can live a normal life as long as their condition does not get out of control. The same applies to COVID-19. I don’t see why a person with diabetes should take any extra protective measures against the virus. The most important thing for me personally is to stay informed on a daily basis and follow the national and international guidelines.
Patricia Gómez Medel: From a personal perspective, I think COVID-19 has provided an opportunity to learn more about diabetes and what we can do as individuals to make personal changes. It’s also an opportunity to look at how we can change the way doctors organise their consultations with people with diabetes, and focus more on diabetes education. The more information and knowledge we have about the condition, the better decisions we can make in response to everything we hear and the more calmly we will be able to live. At the moment, there is a lot of focus and money spent on treating diabetes complications. I think we should invest more on education and prevention.
Are you worried about the long-term impact of COVID-19?
Ehab Ali: I do not have any personal fear as a person with diabetes. I share the same concerns as anyone else. What I think we should all focus on now is how we are going to live after the pandemic, from both an economic and health perspective. As a person with diabetes, I know that I am potentially at risk of medical supply shortages. However, I am sure that the health system in my country will do its best to maintain the required levels.
We have already started to see a positive impact in the virtual communication methods and home-working policies that a lot of companies, universities and schools have adopted. This has also led to a shift in focus among employers, with more emphasis placed on measuring employee efficiency by productivity rather than working hours. I think this is positive because it will allow people with special needs to work from home.
Francesca Ulivi: As a result of the difficult economic situation, with many people unemployed and not receiving any income, the last thing I would do is fund research for type 1 diabetes. This is already difficult in normal times as a cure for type 1 diabetes is not a top priority for most people. My worry is therefore that the focus on COVID-19 will make this situation worse and prevent further research for type 1 diabetes.
I think there has also been a positive impact. People are now more aware of the importance of being healthy and helping each other and they understand that some people – for example the elderly, people with chronic conditions – should be protected more than others.
Dr. Gilberto Mauricio: I think we need to revisit the way that we look after people with diabetes. Diabetes has been around a long time but we still forget how to manage the condition correctly. A very essential aspect has been overlooked, which is providing people with diabetes with the knowledge and responsibility to take care of their condition on a daily basis. In this respect, I consider COVID-19 a great opportunity to highlight the importance that governments have in managing, not only people with diabetes, but also those with conditions such as obesity or hypertension. The pandemic is an opportunity to focus on improving management of diabetes through diet, monitoring and maintaining normal glucose levels and enabling the person with diabetes to participate more actively in the process. I insist on seeing this crisis as an opportunity to invite governments, the health sector, health professionals and the general population to look after their health in general. Not only to think that a person with diabetes is more vulnerable to the virus but that their risk is reduced with good or excellent diabetes control.
Ehab, Francesca and Patricia are members of the IDF Blue Circle Voices network. Learn more about them.
