Diabetes Increases the Risk Of Infection, Even Coronavirus

The number of pre-diabetic and diabetic patients has increased dramatically over the past few decades. Today about 13% of the US population over 18 has diagnosed or undiagnosed diabetes. The primary reason for this has been an exceptional growth in obesity. While we typically discuss diabetes as a significant risk factor for a number of long-term and chronic diseases including cardiovascular disease, now, more than ever the effect diabetes has on the immune system needs to be emphasized.

Research has shown that high blood sugar can lower the effectiveness of the immune system and even release molecules that actively interfere with it. This may allow opportunistic infections such as upper respiratory diseases to take hold and worsen. Further, because proper circulation is compromised in diabetics, patients are not able to fight infections such as pneumonia as effectively. The result is that for many patients, especially those of advanced age, type-2 diabetes represents a significant risk factor for complications associated with coronavirus or COVID-19.

One’s first thought might be to quickly get on medication or insulin, as recommended by a qualified physician or endocrinologist, to get blood sugar under control. Even those who effectively manage their diabetes medically, while at lower risk than uncontrolled diabetics, still have a greater risk than those with regular blood sugar levels.

What can be done?

As a bariatric surgeon, I know that the most effective long-term solution for obesity related diseases, including type-2 diabetes, is weight loss surgery. In fact, patients who undergo a gastric bypass may put their diabetes into remission within days of surgery, even before they’ve lost a significant amount of weight. While the exact reason is still up for debate, we know that bariatric surgery creates hormonal and metabolic changes that truly make a difference.

With that being said, having bariatric surgery at this time is a virtual impossibility, with most elective procedures being suspended in order to care for a potential influx of coronavirus patients. There are however ways that you can change your lifestyle that can dramatically reduce the risk of diabetes.

Diet & Nutrition

Over the years, our diets have become loaded with sugars and processed foods. Changing your diet is by far the fastest way to improve your metabolic health, short of having surgery. It goes without saying that you should eliminate the worst offending sugars – added sugars. These are found in sodas, cakes and many other very sweet items. They can easily be screened on the nutrition label, which now has a separate line for added sugar. But even some natural sugars aren’t great for you. For example, you’ll notice the amount of sugar in various juices is extremely high. In some cases, sugar content can be as much as a regular soda. Don’t be fooled by vitamin and mineral content, as any benefits are more than offset by extreme sugar levels. Moreover, empty carbs such as those in alcoholic beverages, white rice and white bread contribute to added sugar in the diet. These empty carbs don’t offer the nutrition that, for example, whole grains do. And don’t think that substituting for honey is any better – it is still sugar.

Low / No-Calorie Sweetener

You should also be aware of low and no calorie sweeteners. While we thought that this was the answer to our sugar problem about a decade ago, we have come to learn that the problem with sweetness lies both in the gut AND the brain. The brain interprets zero calorie sweeteners in the same way as it does regular sugar and craves more sweetness as a result. While you may be saving a few calories now, you ultimately risk a longer-term sugar-driven calorie binge.

Exercise & Movement

Exercise is the other key component to short and long-term weight-loss. Many of us have let our exercise programs fall by the wayside. As we gain weight, it becomes more difficult to move around, creating a vicious cycle. However, you don’t have to start by running a marathon or pushing yourself to the brink of exhaustion. Walking a half hour a day – just enough to get the heart rate up without feeling dizziness or pain is a great start. Even vigorous housework is often a good option to get the heart pumping and lose some weight.

Vitamins & Minerals

At your last check up, your doctor may have told you that you’re deficient in one or more vitamins and minerals. It is important for all of our bodily functions, including the elimination of inflammation in the body, to have balanced vitamin levels. If your doctor recently suggested supplementation and you haven’t yet started, this would be a good time to take it. However, do not start a new vitamin or mineral regimen without your doctor’s knowledge or advice. Some can be toxic with very damaging results.

How Sustainable is Diet and Exercise Alone?

In our seminar we discuss how only 5 to 10% of patients succeed over the long term with diet and exercise alone. This is certainly true. However, with coronavirus staring at us over the next few weeks to months, this is exactly the time we need that short-term weight loss to improve our immune system and reduce the risk of complications associated with a potential infection.

Once we are able to resume elective surgeries, you may wish to consider a bariatric procedure. A consultation with Dr. Tsuda or Dr. Ryan can offer some insight into your candidacy. And your efforts to lose weight now will not be in vain. Losing some weight before bariatric surgery reduces the risk of surgical and postoperative complications.