Experts say people with diabetes need to be extra cautious of dengue and should take precautions to not get severely affected by it. Dengue could get manifested in an aggressive form especially in people with diabetes with excess body weight, high blood pressure and other related health conditions. Apart from inflammation due to dengue affecting blood glucose levels, dengue fever could also affect appetite putting people with diabetes at extra risk as far as blood glucose fluctuations are concerned.
“Those with diabetes should keep a close watch on their sugar level and also platelet count,” cautions Dr Anil Bhoraskar, senior diabetologist, S L Raheja Hospital, Mumbai. He also points out that those diabetic and are already diagnosed with conditions like heart disease, hypertension and kidney disease would be more vulnerable to complications.
According to a meta-analysis published in PLOS One (a peer-reviewed journal published by the Public Library of Science) case control studies and nine retrospective cohort studies showed that comorbidities may contribute to severe dengue, especially comorbidities like cardiovascular, respiratory disease and renal disease, as well as old age.
Diabetes and dengue: Watch out for episodes of low blood sugar
Dr Bhoraskar says during high fever the patient’s intake of food is grossly limited and the patient doesn’t eat adequate calories leading to weakness. On top of this if they keep on taking the medication particularly the oral drug, they can develop hypoglycemia very often. “This is a dangerous situation,” alerts Dr Bhoraskar.
A complete blood count or CBC test helps determine the count of white blood cells which increase when platelet count reduces. If the platelet count drops drastically and goes below the critical level of 50,000, the patient needs to be admitted to the hospital and be given IV fluids along with platelets transmitters.
“Anybody who encounters this situation needs to be vigilant and especially a person with diabetes because people with diabetes need to manage their vitals well.
Can diabetes amplify dengue complications?
Dr Pramod V Satya, Consultant- Internal Medicine and Diabetologist, Manipal Hospital, Bangalore explains hemorrhagic fever and shock syndrome both are the biggest complications of dengue for any person whose platelet counts are too low.
Dengue hemorrhagic fever is a syndrome where the blood leaks from the blood vessels or capillaries into the body and water accumulates into the lungs, stomach, gallbladder, liver and results in a profound fall in the blood pressure which is called dengue shock syndrome.
Course of treatment
Any person with severe dengue is given IV fluids, platelet transfusion which is the usual treatment that doesn’t affect the blood sugars. In some rare cases steroids are also given so that the platelets may go up.
Dr Satya says just like any other infection, blood sugars may get elevated with dengue.
Dengue caution for people with diabetes
Diabetologist Dr Ashwitha Shruti Dass says any kind of blood thinning medication needs to be stopped in view of the risk of bleeding in people affected by dengue fever.
Dr Bhoraskar says during the fever a person with diabetes should monitor their blood sugar three to four times a day and administer insulin accordingly. He says it is best to avoid oral medication.
“Many times, it gets difficult because the blood clotting is impaired, so it is best to reduce your oral drugs and if the sugars are high then it is better to put the patient on insulin because flexibility of insulin is a lot better than the tablets.”
If the patient has severely low platelet count, then he can get multiple hemorrhages, can bleed in the GI tract and go into shock because of blood loss and dehydration.
Drink fluids to beat dengue
To keep yourself safe it is best for people battling dengue fever to keep themselves hydrated with fluids. They should increase the saline intake, take complete bed rest and take paracetamol to reduce the fever.
“It is highly recommended to have unsweetened fresh juices, coconut water or lemon water with salt to keep dehydration at bay,” says Dr Bhoraskar.
People with diabetes, especially older adults should also take some extra precautions to keep their surroundings clean to avoid getting bitten by mosquitoes, especially if there is stagnant water in their locality and reports of recent outbreak.
Takeaways
- People with diabetes comorbidities and dengue fever need to monitor their sugar levels three to four times a day.
- People on blood thinners need to stop the medication to avoid the risk of bleeding and dengue shock syndrome which can be fatal if not treated on time.
- People with dengue need to keep themselves hydrated and will need IV fluids, platelet transfusion in severe cases
