Vadodara city crossed 13,000 Covid-19 cases on October 11 even as the administration announced that the city has “overcome the first wave”. Six months into the pandemic, medical experts in the city who have been treating Covid-19 infections say that although the virus appears to have toned down in virulence, the biggest challenge is treating persons with diabetes.
Vadodara Covid nodal officer Dr Sheetal Mistry, also an Assistant Professor Surgery at Gujarat Medical Education and Research Society (GMERS)-run Gotri hospital, which has seen close to 6,000 Covid admissions so far, has recommended new standard operating procedures (SOPs) for administering medicines to patients, after his own experience with Covid-19.
Mistry, who got the infection in September along with 10 family members, and has recovered, said the being a diabetic himself gave him a perspective on how the virus acts in the body.
“I had severe cough, body ache, fever, loss of smell and taste. The scans showed about 12% lung involvement and so, I took Remdesivir. I realised that Remdesivir causes severe headache and sedation. I recommend that it should be administered to patients only before bed,” Mistry said.
According to Mistry, diabetics are prone to cytokine storms — an excessive inflammatory reaction in the body. “Sitagliptin helps increase the amount of certain natural substances that lower blood sugar and decrease inflammation. We are recommending this for diabetic patients along with Empagliflozin to decrease heart-related complications. I myself did not go into a cytokine storm because of these two medicines and I am recommending it to all diabetes patients.”
He said by nature, Covid-19 attaches to ACE2 receptors found in lungs as well as in beta cells of pancreas, kidneys, liver and intestines, and causes system inflammation. “Once you are down with Covid-19, all these organs, where glucose metabolism takes place, get affected and the sugar levels shoot up,” he said.
Warning people against the sense of security provided by false negative results of Rapid Antigen Test (RAT), Mistry said, “We have observed that those who tested negative in RAT become careless. General practitioners who do not know the intricacies of the disease also prescribe antibiotics and wait, wasting time. When they get breathless, they come to the hospital. Rampant use of antibiotics in the time of a pandemic will also disturb the equilibrium as we do not have new antibiotics in the pipeline,” Mistry added.
According to a VMC officials, mortality is high among patients with diabetes. “Most diabetics are hypertensive and obese, which has an underlying multi-system inflammation, over the cytokine storm. Gujarat is the diabetes capital as our diet includes lot of sugar, oil and cereals,” he said.
Health experts are also observing an emergence of new diabetics after recovering from Covid-19. “Covid-19 is also causing hyperglycemia. I have seen patients who have recovered with normal sugar levels returning a month later with complaints of weakness and frequent urination. They are getting diagnosed as new diabetics. It is possible that Covid-19 is triggering diabetes. These new diabetics are more at risk of secondary infection and other complications,” Mistry added.
Health officials say that the number of critical patients has reduced drastically. According to Dr Devesh Patel, VMC medical officer for health, patients with mild and manageable symptoms are opting for home isolation. At present, of the 1,806 active cases in Vadodara, 687 are in home isolation while 684 are in private hospitals.
“This has reduced the number of patients in GMERS and SSG to 148 and 177, respectively. Those who need oxygen support or critical care are getting admitted to the hospital. Now, most of the critical cases are those who neglected their symptoms initially,” Patel said.
Vadodara recorded 13,398 Covid-19 cases and 207 deaths till Monday.
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