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BerlinIt can be read everywhere. Older people in particular are particularly ill with Covid 19 infection and have to go to the clinic. Often even in the intensive care unit. But in the meantime it turned out that advanced age is not necessarily in the foreground for the course of the disease. Concomitant and pre-existing diseases are much more crucial. This also includes diabetes, one of the most common diseases. About one in ten Berliners, about 370,000 people, is affected. One or the other may ask the question: Why are we particularly at risk?
Michael Ritter knows the answer. The chief physician of the Clinic of Angiology, Diabetology and Endocrinology of the Helios Clinic Berlin-Buch runs one of the few large special diabetes centers in the capital. He says, “Those who keep their blood sugar levels in the normal range generally have nothing to fear. But undetected or poorly adjusted diabetes affects the immune system.” Even without a crown, surgery, normal illnesses from the flu or pneumonia could be more difficult for a diabetic and lead to more complications, says chief physician Ritter: “That’s why it’s important to you. As protection against infection, it’s important for people with diabetes at all times that their blood sugar is well adjusted. “
Ritter can explain how diabetes weakens the immune system: “High blood sugar levels change certain building blocks of protein and therefore disrupt the function of white blood cells, which are responsible for the body’s defense. You can even see this in the lab under a microscope. Immune cells digest pathogens worse. “
But there are other risk factors that diabetics should be aware of for now. “If there is also high blood pressure and cardiovascular problems, diabetes patients with a weakened immune system with a Sars-CoV-2 infection are at even greater risk of a serious course of the disease,” said Ritter. “The virus mainly affects the lungs and the immune system has to fight it there. However, this fight can in turn put massive pressure on the heart through the circulatory system. ” This alteration is even more dangerous than the lungs damaged by the virus. Lack of oxygen could be compensated by artificial respiration, and in an extreme emergency, the entire lungs would be replaced by a machine. “But the heart has to pump much more because all the organs are affected. Ultimately, this can lead to cardiovascular failure, “said Ritter.
The whole new thing is realizing that even being overweight is one of the risk factors. Recent scientific studies from France and China have shown that more than three-quarters of the crown patients in the intensive care unit suffered from obesity.
Because diabetes patients, unlike healthy people, are at increased risk for corona, they need medical advice and help now more than ever if their blood sugar levels are not correct. “The first contacts here are general practitioners, internists, and ideally diabetologists,” says expert Ritter.
But the following problem already threatens here. The German Diabetes Society (DDG) has already observed a sharp decrease in the number of patients in doctor’s offices and outpatient clinics. “There is great public uncertainty,” warned DDG President Monika Kellerer. “Many people no longer notice important medical appointments or stay home with sharp complaints. Either out of respect for the health system, due to poorly understood exit restrictions, or fear of infection with the Corona virus, “says Monika Kellerer, who is also Medical Director of the Center for Internal Medicine I at Marien Hospital in Stuttgart. It requires that the symptoms of the disease be taken seriously, particularly patients with diabetes with multiple diseases should seek medical help immediately if their blood sugar levels are poor or if their health changes.
Michael Ritter also advises: “Like us in our outpatient clinic, other colleagues in Berlin now offer hours of telephone or video consultation. Even measured values can be sent to the doctor before the phone call and then give advice. “
This applies at least to those affected, which the doctor already knows. However, because diabetes doesn’t hurt and often doesn’t cause symptoms for a long time, your family doctor should check your blood glucose every two years starting at age 35. In people at high risk for diabetes, tighter controls are recommended. This includes overweight patients, who exercise little, have high blood pressure and high cholesterol.
Urine tests with pharmacy dipsticks only show any late-onset diabetes. But in Crown times, even these inaccurate values could at least provide the first indications.
However, caution is recommended when the first symptoms appear. For example, those affected feel tired and tired. They have to urinate frequently, they are very thirsty and they drink a lot. Wounds heal worse. Unexplained weight loss can occur. If you experience numbness in your arms or legs or even visual disturbances, diabetes can even be very advanced.
If you already know you have diabetes, you should now check your values more closely. This is particularly true for diabetics with high blood pressure, cardiovascular disease, and being overweight.
The normal value for blood sugar should not exceed 200 milligrams per deciliter or 11.1 millimoles per liter, the unit that used to be common in the GDR. The long-term HbA1c blood sugar level should be less than 7.5 percent.
Diabetics are used to taking automatic measurements regularly. “However, if you are quarantined or experiencing cold symptoms, we recommend that you determine the values about twice as many times,” says Chief Medical Officer Ritter. He also advises to continue taking the medication prescribed by the doctor in question and exactly as directed.
In type 2 diabetes, these are often the active substances metformin, which inhibits the formation of new glucose in the liver, and the so-called gliflozins, which remove excess sugar from the body with urine. However, if those affected were actually infected with the coronavirus and the course of the disease is severe, it is generally necessary to discontinue these medications and temporarily switch to insulin injections. “However, this starts in the clinic,” says diabetologist Ritter. “You shouldn’t do that on your own.”
Although all clinics in Berlin must keep beds free for Covid 19 patients and postpone non-urgent treatments, there is always sufficient capacity for diabetes patients in an emergency. “Most diabetics can be employed on an outpatient basis by the resident physician,” says chief physician Ritter. “A hospital stay is only necessary if this doesn’t work or if diabetes goes off the rails.” However, this is possible at any time because serious illnesses must be prevented.
Contact person: Anyone looking for a diabetes specialist in your area can find the addresses of clinics and certified clinics on the Internet at www.deutsche-diabetes-gesellschaft.de
Expert advice: more exercise, less food
- Remedy without medication is sometimes possible: The most common type 2 diabetes can often be favorably influenced by changing to healthier eating and living habits. In the early stages, regular exercise and weight loss can only help patients normalize or at least improve blood sugar levels even without medication, according to experts.
- Nutrition: “Especially in times of high stress, like now with exit restrictions, many tend to eat unhealthy,” says chief physician Michael Ritter. “Then you eat too sweet, too salty, and too fat. Healthy eating is more important than ever now. “For those who eat frustration, the diabetes doctor still has one tip:” Have fresh fruits or vegetables in portions every day. For example, peel and cut carrots. You can access it from time to time. ”
- Sport: In addition, Ritter advises you to exercise more, but you should not overdo it when you enter, but simply increase a little each day. Nordic walking, cycling or just a brisk walk for seniors are particularly suitable: “If the exercise program is combined with gymnastics and perhaps organized together with the family, it can even be a lot of fun.” Alba Berlin’s daily sports lesson (www.youtube.com/albaberlin) is particularly suited to this: “Everyone can, of course, do this on video, along with children, parents, grandparents or friends. It’s really fun and increases the effect on health. ”
