COVID-19 and Diabetes Mellitus Management from an Endocrinologist View

By Dr. Akshay Chugh in Internal Medicine

Sep 12, 2020

The COVID-19 pandemic not only triggered a global health crisis but also deeply disrupted the management of chronic diseases—especially diabetes mellitus, a condition that already burdens millions worldwide. As healthcare systems pivoted to fight the virus, many people with diabetes faced new challenges that severely impacted their health outcomes. At Metro Hospitals, recognized as one of the top diabetes hospitals in Delhi, our expert panels have been actively analyzing this intersection of infectious and chronic disease to guide safe and effective care.

Also Read: How Dangerous Are the New COVID-19 Variants in 2025?

Why Diabetes Patients Were at Greater Risk During COVID-19

Emerging global data clearly shows that individuals with both Type 1 and Type 2 diabetes experienced significantly higher morbidity and mortality from COVID-19. In many hospitals across the world, including in India, the following patterns were observed:

• Increased ICU admissions among diabetics
• 3x higher mortality rates in diabetic patients
• Worsened glycaemic control due to infection and medication side effects (notably steroids)
• Complications such as Diabetic Ketoacidosis (DKA), lactic acidosis, and uremic acidosis

This alarming trend has been attributed to a combination of biological and systemic factors.

Also Read: Myths And Facts About Covid-19 Vaccines

Key Factors That Worsened Diabetes Management During the Pandemic

1. Lifestyle Disruptions
2. Sedentary living during lockdowns
3. Stress related to job loss, financial insecurity, and isolation
4. Disrupted sleep and dietary habits
5. Limited Access to Routine Care
6. Many hospitals converted into dedicated COVID facilities
7. Diabetic and endocrinology OPDs were temporarily closed
8. Patients avoided hospitals due to fear of infection
9. Lack of Information and Monitoring
10. Unclear guidelines on insulin use and medication adjustments
11. Poor awareness of sick-day rules and glycaemic targets
12. Infrequent or no home blood sugar monitoring
13. Shortage of Specialists on Ground
14. In many cases, young residents or general physicians handled critical care for diabetic COVID patients
15. Complex insulin therapy, fluid management, and electrolyte correction were often mismanaged due to lack of experience

Also Read: Impact of Increased Screen Time in Children A Burning problem in Covid Era

What Endocrinologists Observed Firsthand

At Metro Hospitals, we observed that a high percentage of COVID-positive patients also had pre-existing diabetes or were diagnosed during the course of illness (stress-induced hyperglycemia). The infection itself, coupled with the use of steroids, increased stress hormones & inactivity, led to:

• Escalated blood glucose levels
• Severe insulin resistance
• Life-threatening complications like DKA

In critical care, insulin infusions and intensive monitoring became essential. We opted to discontinue metformin in serious COVID cases and instead emphasized insulin-based protocols or DPP-4 inhibitors where appropriate. Electrolyte imbalances, dehydration, and septic conditions made glycemic control highly complex and required specialized intervention.

Also Read: Diabetes and Hypertension Care during COVID-19 Pandemic

Recommendations for Diabetic Patients During and After COVID

As a diabetes specialist at Metro Hospitals, here are some key recommendations for individuals with diabetes or those at risk:

 Medical Management

• Stick to prescribed medications including oral hypoglycemics, GLP-1 analogues, and insulin.
• In severe cases, initiating insulin therapy early with a basal-bolus regimen is recommended for effective glycemic control.
• Monitor blood sugar at home regularly, especially during illness or stress.
• Avoid self-adjusting medications without consulting your endocrinologist.

Diet & Nutrition

• Follow a balanced diabetic diet: High in protein, fiber, and healthy fats.
• Limit high glycemic foods like white rice, sugar, fried items, and refined carbs.
• Choose healthy fats such as those found in olive oil, nuts, and seeds, while reducing the intake of saturated fats like butter, ghee, and processed oils.

 Physical Activity

• Engage in a minimum of 150 minutes of moderate-intensity aerobic activity each week—options like brisk walking, cycling, or swimming can significantly improve cardiovascular health, enhance insulin sensitivity, and support overall well-being.
• Add strength/resistance training at least twice a week.
• If outdoor exercise is not feasible, follow guided workouts or yoga at home.

 Mental Health & Routine

• Manage stress through meditation, breathing exercises, or counseling.
• Maintain a regular sleep schedule & reduce screen time before bed.
• Stay socially connected via virtual calls to reduce isolation-related stress.

Safe Healthcare Access Matters

One major lesson from the pandemic is this: chronic conditions cannot be ignored during a public health crisis. Delaying check-ups or medication refills can have dangerous consequences. Metro Hospitals ensures COVID-safe facilities with separate non-COVID OPDs, teleconsultations, and strict hygiene protocols to help patients continue their care without fear.

Also Read: A recipe to allay fears of cardiac patients keeping away from hospitals for fear of COVID

Final Words from Metro’s Endocrinology Experts

COVID-19 has taught us the importance of resilience—not just in fighting infections but in maintaining chronic disease control during turbulent times. People living with diabetes must prioritize regular care, proactive lifestyle management, and ongoing communication with their healthcare team. Prevention and preparedness are our best tools for future health emergencies.

At Metro Hospitals, Delhi, our dedicated endocrinologists and diabetes specialists are here to provide holistic, personalized care to help you manage diabetes safely and effectively—no matter the circumstances.