COVID-19 and diabetes: perspectives from South-East Asia

Over 87 million people are living with diabetes in the International Diabetes Federation (IDF) South-East (SEA) Region, which comprises of India, Bangladesh, Nepal, Mauritius, Maldives and Sri Lanka. These countries have not been spared by the COVID-19 pandemic and, like in other parts of the world, various restrictive measures have been put in place by the national authorities to prevent the spread of the virus.

People with diabetes and health professionals in the region have been impacted in many ways. We asked IDF SEA Region Chair, Dr. Shashank Joshi, to share his insights on what the impact has been and how, in the longer term, COVID-19 will shape the lives of people with diabetes and health professionals in the region.

What has been the impact of COVID-19 on people living with diabetes in your region?

The IDF South-East Asia region, which includes India, Nepal, Bangladesh, Sri Lanka, Mauritius and Maldives, has the second largest population of people living with diabetes. Due to the COVID-19 pandemic, people with diabetes in the region have been suddenly locked in. This has been a challenge and many have had huge issues handling this. However, I think people with diabetes in the region have come out bravely and faced the challenge in a very good way.

Apart from looking after themselves, people with diabetes have had to ensure that they have adequate supplies of medicines and adequate access to healthcare services. They have also had to make sure that they could handle emergencies like hypoglycemia or diabetic ketoacidosis, and complications like those affecting the heart and kidneys. I think our people living with diabetes have risen to the occasion, connected to the healthcare world and handled the COVID-19 situation very well.

People with diabetes are a vulnerable group and so they have received special attention. When we analysed COVID-19 deaths in large cities like Mumbai and Delhi, we found that anywhere between 10 to 30% of people who died from COVID-19 were living with diabetes.

We have therefore emphasized the importance of maintaining good blood glucose control in local media and on social media, and reached out directly to people with diabetes with this information. We have particularly focused on people with diabetes who are elderly or living with complications, telling them to stay home, stay safe and stay clean. We have also tried to ensure that access, availability and affordability of medication and care did not become a problem.

What has been the impact of COVID-19 on diabetes health professionals in your region?

Health professionals who are taking care of people living with diabetes have been under a lot of strain and distress due to the COVID-19 pandemic and the lockdown measures put in place. They have had to manage people living with diabetes from their homes, ensuring that they comply with diet and exercise, and are taking the medications they need to manage their blood glucose optimally. They have been very actively involved in counselling, guidance and screening for people in the pre-COVID phase.

A lot of our healthcare staff have been beyond their call of duty. Due to resource limitations, diabetes health professionals working in hospitals throughout the region have also had to care for people affected by COVID-19. Many have also gone into the community as volunteers to serve as “COVID warriors.” In Intensive Care Units (ICUs), a lot of hyperglycemia is occurring in people with COVID-19 and this, in many cases, is being managed by diabetes health professionals.

I think all of our healthcare workers have risen to the occasion.

How have national authorities responded to the situation?

In the South-East Asia Region, all governments have risen to the occasion and handled the situation as a public health emergency. They have not only imposed lockdowns, ensuring that people stay safe at home, but also provided education in terms of hygiene and overall health and well-being. Appropriate screening strategies and care have been conducted for both COVID-19 and non-COVID conditions, including diabetes complications such as cardiovascular disease, foot care and kidney failure. All these have been addressed by public health authorities to ensure that no major issues occur for non-COVID care.

How has the pharmaceutical industry and civil society responded?

When there is a pandemic like COVID-19, everybody, including civil society, associations and public health authorities, rises to the occasion. Throughout the region, we have seen an excellent partnership between trade associations, the pharmaceutical industry, government and medical and healthcare associations. They have all collaborated effectively in terms of education, access to medicines, and connecting with people living with diabetes to ensure that they get the support they need.

What do you think will be the longer-term impact of the COVID-19 pandemic on people with diabetes and health professionals?

The COVID-19 pandemic has some similarities with the HIV epidemic. When a communicable disease hogs the limelight, other conditions like diabetes are overlooked, even though they are responsible for one death every eight seconds. We will see a new world order when this pandemic is over. We will see distancing. We will see a digital world. We will see virtual conferences in a much bigger way. We will see working from home as a new normal. We will also see a more connected world, a global virtual village. I feel that diabetes will benefit because we will be able to make a larger impact for people living with diabetes.