Coronavirus a threat to people with diabetes

45-year-old Thomas Nyandoro Kauzi, who lives in Surungai, Kapsabet, Nandi county has been living with diabetes and hypertension since 2008.

He worked as a hotel manager but in that year in July, he fell ill….forcing him to take tests that confirmed his worst fears.

“Shida hii sikugundua at once. I was ok in July. Nilikuwa na kiu kwanza,” Peter Nyandoro told Citizen TV. “Najua hii ugonjwa imeua watu wengi wakati huu lakini wengi wanaogopa kuongea.”

He revealed that he spends Ksh. 35,000 every month to purchase drugs for both hypertension and diabetes, and the right food.

He has to eat 5 meals in a day, avoid sharp objects that can cause wounds. If it is not managed, complications arise such as chills, fever, hindered vision and body weakness.

“Mimi sitangamani na watu..siwezi kutoka bila mask…siwezi. Matanga sijaenda.hii kitu lazima ukulele vizuro. Lazima ujipange ukule ushibe kabla utoke. Hii kitu haifai kulipuka. Avoid stress. Hii si ugonjwa ati ya kuua ukijitunza.”

But during this time of COVID-19, managing his condition is becoming extremely difficult; his wife, who works as a B.O.M teacher in a private school is out of work.

“For diabetes type 1 and type 2, the problem is the production of insulin. For type 1, the amount of insulin being produced is low or almost none. For type 2, the insulin is there but the sensitivity in doing what it’s supposed to do is low..the high sugars are the problem. For people with high amounts of sugar in their blood, the virus thrives in such an environment. Diabetes suppresses the immunity. It renders you powerless to fight the disease.”

She adds: “What COVID does is that it really damages the lungs and how one is breathing. Then it leads to the distress in breathing. Diabetes Mellitus (dm) as a distinctive comorbidity is associated with more severe disease, acute respiratory distress syndrome and increased mortality .”

On his part, Dr. Mark Nanyingih who is an epidemiologist said: “When someone’s immunity is compromised, not just for diabetes but also other non-communicable diseases like hypertension, the vulnerability to such an infection is very high.”

With scientists still trying to understand the SARS-COV2 virus, other scientists have documented a possible association between ACE2 receptor (angiotensin -converting enzyme 2) and diabetes mellitus.

ACE2 is largely expressed by cells in the lungs, kidney, intestines, and blood vessels. This type of enzyme plays an important role in protecting the lungs against acute respiratory distress syndrome.

ACE2 expression is reduced in patients with diabetes, which might explain the increased predisposition to severe lung injury with COVID-19 but at the same time, too much expression of ACE2 is also counterproductive in COVID-19. The virus utilizes ACE2 as a receptor for COVID -19.

Dr. Nanyingih explains: “ACE2 basically is a Y-shaped receptor, the virus easily binds itself on to it.”

Patients with diabetes taking ACE2 stimulating drugs widely used to manage the condition, may experience the entry of the SARS-COV2 virus which may result to more severe and fatal disease.

Of Kenya’s COVID-19 deaths, diabetes has been a frequent preexisting condition. Dr. Doreen Lugaliki, Kenya’s first doctor to succumb to COVID-19, was unaware that she had diabetes.

Dr. Moraa states that: “Patients with diabetes may experience a complication like ketoacidosis which can prove to be fatal.”

According to a Kenya National Bureau of Statistics (KNBS) report released on Thursday, 15 per cent of households reported having at least one member living with diabetes.

So what should people living with and managing diabetes do?

Dr. Moraa says: “They should first understand that they are a vulnerable population. They should maintain the containment measures but besides that they should avoid going out. If you have a family, let them go out to the mall for you. You don’t need to always go to the hospital, go only when you have a doctor’s appointment.”

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