1) People with diabetes face worse outcomes from COVID-19, not a greater chance of contracting the virus. Those with uncontrolled diabetes and other comorbidities like heart disease are at highest risk. 2) The risk of COVID-19 complications is lower for those with well-controlled diabetes. Well-controlled diabetes means monitoring blood sugar 4 times daily, quarterly HbA1c checks below 8%, and blood sugar levels below target ranges. 3) Proper diabetes control during quarantine requires a healthy diet, daily exercise, stress management, regular monitoring, taking medicines on schedule, and maintaining optimal blood sugar levels.

1. Diabetes care during
quarantine period
Dr. Tejas Limaye (M.Sc. Ph.D. RD.)
Certified Diabetes Educator

2. Poll 1
Are people with diabetes more
likely to get COVID-19?
1.Yes
2.No
3.Not Sure

3. COVID-19 and Diabetes
People with diabetes are likely to face
worse outcomes, not greater chance of
contracting the virus
In China, infected people with diabetes
had much higher rate of complications
than infected people without diabetes

4. COVID-19 and Diabetes
Fluctuating sugars (roller coaster effect) – more
chances of complications even if HbA1c is good.

5. COVID-19 and Diabetes
People with uncontrolled diabetes and
having co-morbidities of diabetes like
heart disease are at most risk.

6. Poll 2
Who has maximum risk of getting
COVID-19 complications?
1. A person with diabetes
2. A person with uncontrolled diabetes
3. A person with uncontrolled diabetes and
having co-morbidities of diabetes

7. The risk of getting complications of COVID-19
in people with diabetes is likely to be lower
if the diabetes is well controlled!
COVID-19 and Diabetes – Good News
Diabetes Equation:
High BSL X Time = Trouble!

8. What is well controlled diabetes?
• Pre-requisite: Monitoring blood sugars 4 times
per day (or more) – pre-meals and bedtime
• Checking HbA1c quarterly
• FBSL – below 140 mg/dL
• PPBSL / RBSL – below 180 mg/dL
• HbA1c – below 8%
• ‘Time in range’ – important

9. How to control diabetes
Diet
Medication
Regular
Monitoring
Exercise
Stress
management
Diabetes
Control

10. Regular Monitoring
• Home monitoring of glucose – glucometer /
CGMS / urine test (sugar, ketones)
• Foot checkup – daily
• Weight monitoring – weekly
• Annual checkup – can be postponed during
quarantine period if there is no active
complication / urgent issue

11. Diet
• Fasting – Feasting: Roller coaster of sugars
• Fiber – fresh fruits and vegetables (5 servings/day).
• If not accessible – sprouts, home gardening
• Stock on – fenugreek seeds, chia seeds, isabgol
powder, flaxseeds, garlic
• Limit: tea – coffee, sweets, bakery items, packaged
food, smoking, alcohol
• Limit salt, bad fats, stop sugar
• Fluids: Liberal unless any
restriction suggested by doctors
• Vitamin C, Vitamin D, Zinc
• Supplements?

12. Exercise
• Quarantine period is not an excuse!
• Aim for atleast 60 min home workout daily
• Combination of –
– Cardio (spot jogging, skipping, walking on terrace,
stationary cycling)
– Weight training (push ups, pull ups, squats,
lunges, planks, benchdips)
– Flexibility (stretches, yoga, suryanamaskar)
• Those with co-morbidities – exercise as per
the doctor’s advice

13. Stress Management
• Quarantine period can increase stress
– Uncertainty, economic stress, hopelessness
• Stress can further deteriorate glucose control
• Look for symptoms
• Find the stressor – Avoid, Alter, Adapt, Accept
• Find the ways to cope up
– Hobbies, go close to nature, workout, read, watch
– Adequate sleep
– Meditation, breathing exercises

14. Medicines
• Take on time, specifically with regards to food
• Don’t self adjust the dose of medicines / stop
• Order medicines online preferably
• Store at optimum temperature, conditions
• In case of unavailability of medicine in quarantine
period, talk to your doctor for alternative brand
names / alternative medicines

15. Poll 3
What is important for good control of
diabetes?
1. Diet
2. Exercise
3. Stress management
4. Regular Monitoring
5. Medicines
6. All of the above