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Wednesday, August 17, 2022

Covid and diabetes collide in a train wreck of public health consequences

Before coronavirus vaccinations were widely accessible, David Donner, a retired truck driver in rural Alabama, spent six hours with his wife in a crowded emergency hospital after an insect bite on his back got infected with the virus. They both started feeling the typical signs of Covid-19 a few days after the first occurrence.

Debra Donner recovered rapidly, but her husband, Mr. Donner, 66, was sent to the intensive care unit. I was surrounded by medics in hazardous suits since the illness had hardly slowed her down,” he added. “It was a nightmare.” A wheelchair has become necessary because of his sluggish recuperation. The fact that I’m walking 20 feet and panting and puffing like I’ve just run 20 miles is ridiculous.”

The Donners are not perplexed as to why their experiences were so disparate: He suffers from diabetes, a chronic condition that impairs the body’s capacity to manage blood sugar levels and inevitably causes damage to the circulatory system, renal function, and other essential organs in the process.

People with diabetes, maybe more than any other demographic, have been particularly heavily struck by the epidemic, second only to the elderly and nursing facility patients. Recent studies suggest that people with diabetes account for 30 to 40% of all coronavirus deaths in the United States, a sobering statistic that has been overshadowed by other bleak data from a public health disaster that is on track to claim a million lives in the United States by the end of this month.

People with diabetes are particularly vulnerable to severe illness caused by the Covid virus, in part because the disease impairs the immune system, but also because those with the disease frequently struggle with high blood pressure, obesity, and other underlying medical conditions that can significantly worsen the effects of a coronavirus infection, which is a virus that spreads through the air.

Diabetes is a pernicious illness that is both widespread and invisible, in part because the majority of individuals who have the condition do not seem to be unwell on the outside. Even though it affects 34 million Americans, or 13 percent of all adults, it receives much less financing and public attention than other big killers such as cancer, Alzheimer’s disease, and heart disease.

Although political leaders and the general public are beginning to lose their grip on the epidemic, researchers, clinicians and other experts in the field are hoping that disproportionate suffering and death among people with diabetes will spur renewed attention to the disease, which claims 100,000 lives each year and consumes one out of every four dollars spent on health care.

The results of a study released last month indicated that patients who recovered from Covid were 40 percent more likely than the general population to be diagnosed with type 2 diabetes after 12 months, however researchers have yet to establish if there is a link between the two disorders.

Doctors have also observed a significant increase in the number of young individuals being diagnosed with type 2 diabetes over the previous two years, an increase that many feel is linked to the dramatic increase in paediatric obesity that occurred during the epidemic. The Pennington Medical Research Center at Louisiana State University’s Pennington Medical Research Center has seen children come in so sick and dehydrated that they have required intensive care unit treatment. Dr. Daniel Hsia, a diabetes specialist at the Pennington Medical Research Center, said that this has happened.

Farmhand Betty Angeles, age 59, has firsthand experience with the difficulties of controlling diabetes among low-wage workers in and around Santa Barbara, California. In addition to her profession as a home cleaner and pastry chef, Ms. Angeles is also employed at the Sansum Diabetes Research Institute as a community health worker, where she assists Spanish-speaking customers in navigating the complications of diabetes treatment.

Sansum offers services that make it easy for people to maintain their health. That means testing their blood sugar levels on a regular basis, encouraging clients to exercise, even if it means jogging in place for 15 minutes between jobs, and teaching them to prepare meals that emphasise fresh produce over starchy carbohydrates such as bread, rice, and tortillas, which can interfere with the body’s ability to regulate glucose levels in the bloodstream.

Arianna Larez, who heads the institute’s type 2 diabetes programme, believes that Ms. Angeles and other outreach workers who have deep connections in their communities are essential to the program’s success. In particular, she feels that the especialistas, as they are called in Spanish, should be given some credit for one hopeful data point: despite the fact that many people have been infected by the coronavirus, none of Sansum’s 400 customers has died as a result of Covid so far.

Experts warn that in order to solve the nation’s diabetes issue, more than just increasing the number of community health workers would be required. Effective public education efforts to instil the value of exercise and good eating are required, as are fundamental adjustments to a food system that favours inexpensive, processed foods – a difficult task given the political clout of the food and beverage industry.

Research suggests that state and municipal governments may make a difference via initiatives such as subsidising fresh fruit for low-wage workers and zoning regulations designed to attract supermarkets to so-called food deserts, according to the researchers.

Jonathan James
I serve as a Senior Executive Journalist of The National Era
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