TRYING to stay healthy after contracting COVID-19 is one hurdle, but managing it with a chronic disease can be especially challenging. Based on what is known about COVID-19, adults living with an underlying medical condition such as cardiovascular problems, hypertension, or obesity are at heightened risk for severe illness, especially people living with diabetes.
The ramifications of contracting COVID-19 with diabetes underscore the importance of getting vaccinated. The benefits of the vaccine greatly outweigh the risks, especially in a patient population with diabetes. As a result, experts are emphasising that people with diabetes should make every effort to get the COVID-19 vaccine.
Dr Olubiyi Adesina, a consultant endocrinologist, Federal Medical Centre, Abeokuta, Ogun state says people with diabetes and other underlying conditions may have a higher risk of developing severe complications such as difficulty in breathing, blood clots or pneumonia.
“They get more severe diseases and so mortality will be higher in people who have diabetes and other underlying conditions than people who have COVID-19 but who had no prior illnesses. So as the country wants to roll it out, people with diabetes should be on the priority list, after the health workers,” he said.
In the majority of people, the symptoms of COVID-19 are relatively mild and do not require specialist treatment in a hospital. Mild symptoms may include a fever, a cough, a sore throat, tiredness, and shortness of breath.
Dr Adesina, however, assures that the vaccines are safe for people with diabetes as scientists, governments and industry all around the world have focused their attention on this one shared goal.
He adds, “When you get the vaccine, the body will start to produce what’s called an immune response. This is nothing to worry about. The body is just reacting to the vaccine because the vaccine is new. The body needs the energy to produce this immune response, so it may release some extra glucose (sugar).
“This is what leads to blood sugar increases. But, the increase in blood sugar is very marginal, not that it will go awry. The raised blood sugar cuts across everybody, not only people with diabetes. So, they should have no cause for concern.”
The expert also added that they need not fear the vaccine interfering negatively with their diabetes medications.
Dr Adesina, however, said people with diabetes can protect themselves from contracting the virus in the same way as everyone else by frequently washing the hands with soap and water, using an alcohol-based hand sanitiser when soap and water are not available, avoiding frequently touched surfaces when possible and frequently disinfecting any potentially contaminated surfaces such as countertops, tabletops, and door handles.
Currently, authorized vaccines such as Pfizer-BioNTech and Moderna appear to be safe and effective for adults with diabetes. Rigorous clinical trials tested the safety of these vaccines in adults of all ages, races, and ethnicities, as well as chronic health conditions.
The Pfizer-BioNtech trial included 3,150 people with diabetes (8.4per cent of trial participants). The Moderna trial included 2,858 people with type 1, type 2, and gestational diabetes (9.4 per cent of trial participants). Among the trial participants with diabetes, the Pfizer-BioNtech was 95 per cent effective, and the Moderna vaccine was 100 per cent effective.
Previously, studies in Diabetes Care found that people with type 1 or type 2 diabetes are three times more likely to be hospitalized or experience severe COVID-19 illness compared with people without diabetes.
Two studies from the United Kingdom showed a similar risk. An October 2020 study in The Lancet Diabetes & Endocrinology found that people with type 1 or type 2 diabetes were two to three times more likely to die from COVID-19 in the hospital than people without diabetes. And a December 2020 study in The Lancet Diabetes & Endocrinology found that people with type 1 or type 2 were more likely to die or to be treated in the intensive care unit for COVID-19.
Howbeit, even without the COVID-19 vaccines, Professor Temitope Alonge, chairman, Oyo State COVID-19 task force said blood sugar could become deranged in individuals without diabetes that come down with COVID-19.
According to him, “when they are on steroids, it is mandatory for them to have their blood sugars checked regularly to avoid it becoming deranged. Their blood sugars may actually rise because of alteration of the cortisol level.”
Dr Olumide Sogaolu, a consultant chest physician at the University College Hospital (UCH), Ibadan says individuals with asthma should also take the COVID-19 vaccine and it is safe for them. There is also no fear of its interaction with medicines used to treat and prevent narrowing of airways.
According to him, “the vaccine will protect them from coming down with the severe form of COVID-19 infection. They are safe as they don’t contain agents that can make the airways to become inflamed, narrow and swell and produce extra mucus, which makes it difficult to breathe.”
Dr Sogaolu added, “despite vaccination against COVID-19, they still need to continue to follow COVID-19 precautionary public health measures such as masking, physical distancing, handwashing, respiratory and cough hygiene, avoiding crowds, and ensuring good ventilation.”
Meanwhile, medical experts say that there’s little reason to worry that COVID-19 vaccines are not likely to interfere with common prescription drugs. It comes down to the fact that most of the maintenance medications go nowhere near the system in the body that the COVID-19 vaccines affect the immune system.
Stephen Moll, a professor of medicine at the University of North Carolina (UNC) and the medical director of Clot Connect at the UNC Blood Research Center, reiterated in a January blog post that people on blood thinners like warfarin should get the COVID-19 vaccine.
Also, William Schaffner, M.D., an epidemiologist and professor of preventive medicine and health policy at Vanderbilt University says since statin, a medicine to guard against high cholesterol interrupts the cholesterol production and has nothing to do with the immune system, there is no cause for any worry.
William Moss, M.D., executive director of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health said although people who are HIV positive and take one or more medications that affect their immune systems, they should still take the COVID-19 vaccine but it could decrease the efficacy of the vaccine.
Purvi Parwani, MD, a cardiologist at Loma Linda University International Heart Institute, says its benefits far outweigh the risks for people with cardiovascular risk factors, long-term heart and circulatory conditions, history of heart attacks and stroke survivors getting vaccinated.
He adds, “Millions of people have been vaccinated so far, and we haven’t seen any dangerous trends in either of the two vaccines. There is no evidence so far to suggest that patients with cardiovascular issues have more side effects than the general population.”
Many organisations have backed the COVID-19 vaccine: the U.S. Food and Drug Administration (FDA) approved the Pfizer-BioNTech and Moderna vaccines, the Center for Disease Control and Prevention (CDC) recommends vaccination and a recent statement by the American Heart Association (AHA) encouraged cardiovascular patients to take the vaccine.
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