Presenting new epidemiological and diabetes-related impact data.
The association between circulatory risk factors and pathologies and the COVID-19 pandemic is becoming more obvious as more people affected receive treatment worldwide. Each member of the Global Coalition for Circulatory Health (GCCH), which brings together international, regional and national stakeholders in circulatory health to drive the urgent action needed to combat heart disease and stroke, has been working actively within its own speciality and constituencies to provide relevant and timely information related to the crisis.
There is, however, a unique opportunity for GCCH to provide a comprehensive and global perspective on circulatory risk factors, such as hypertension, diabetes, obesity, and tobacco use, and outcomes, including renal failure, vascular problems, and cardiovascular disease, associated with COVID-19.
We are therefore delighted to invite you to join our upcoming webinar series, moderated by the Past President of the World Heart Federation, Prof David Wood.
The recordings of all the webinars are available below.
Circulatory Risk Factors for COVID-19
COVID-19 and Circulatory Conditions: Mitigating Poor Outcomes
Supporting the Healthcare Workforce: COVID-19 and Public Health in the Circulatory Space
In response to the current COVID-19 pandemic, governments in many countries have restricted the movement of their citizens, confining them to the home environment. Public exercise facilities such as gyms, sports centres and swimming pools have been closed.
Regular physical activity is of great benefit to the general population and even more for people living with chronic conditions like diabetes. Daily physical activity is an integral part of diabetes management, helping to maintain blood glucose at recommended levels.
Physical activity should be seen as a hobby and a valuable tool to overcome the monotony of the difficult confinement that many people around the world are currently experiencing.
Below are a series of daily exercises that can be performed at home, provided by ANIAD, the Italian National Association of Athletes with Diabetes. The exercise intensity of each activity is comparable to one hour of brisk walking, resulting in an energy expenditure of 150-200 Kcal.
Other ways to train at home:
These suggestions can be used to develop short, fragmented or continuous training sessions. Here is an example of a series of “total body” exercises involving all main muscle groups, which anyone can do at home:
Make sure to avoid overload and adapt exercise intensity to individual ability and fitness level. It is also important to monitor your health before, during and after exercising.
The recommendations above were developed and kindly made available by the Scientific Council of ANIAD: Drs. Gerardo Corigliano, Giuseppe Pipicelli, Felice Strollo; Alessio Calabro’ and Matteo Vandoni.
COVID-19 is a new and potentially serious coronavirus. The World Health Organization (WHO) has declared the COVID-19 outbreak to be a public health emergency of international concern.
There are many coronaviruses, ranging from the common cold to much more serious viruses such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). They are viruses that have been transmitted from animals to people. In severe cases, coronaviruses can cause infection in the lungs (pneumonia), kidney failure and even death. At present there is no vaccine against COVID-19.
Common signs are typical flu-like symptoms: a fever, cough, breathing difficulties, tiredness and muscle aches. Symptoms usually start within 3-7 days of exposure to the virus, but in some cases it has taken up to 14 days for symptoms to appear.
People of all ages can be infected. For many (more than 80% of cases), COVID-19 is mild, with minimal flu-like symptoms. Some have not shown symptoms or only very mild symptoms, more like a common cold. The majority of people who have caught the virus did not need to be hospitalised for supportive care. However, in approaching 15% of cases COVID-19 has been severe and in around 5% of cases it has led to critical illness. The vast majority (around 98%) of people infected to date have survived.
Older people and people with pre-existing medical conditions (such as diabetes, heart disease and asthma) appear to be more vulnerable to becoming severely ill with the COVID-19 virus. When people with diabetes develop a viral infection, it can be harder to treat due to fluctuations in blood glucose levels and, possibly, the presence of diabetes complications. There appear to be two reasons for this. Firstly, the immune system is compromised, making it harder to fight the virus and likely leading to a longer recovery period. Secondly, the virus may thrive in an environment of elevated blood glucose.
Like any other respiratory disease, COVID-19 is spread through air-droplets that are dispersed when an infected person talks, sneezes or coughs. The virus can survive from a few hours up to a few days depending on the environmental conditions. It can be spread through close contact with an infected person or by contact with air droplets in the environment (on a surface for example) and then touching the mouth or nose (hence the common advice circulating on hand hygiene and social distancing).
For people living with diabetes it is important to take precautions to avoid the virus if possible. The recommendations that are being widely issued to the general public are doubly important for people living with diabetes and anyone in close contact with people living with diabetes.
Healthy nutrition is an essential component of diabetes management. It is therefore important for people with diabetes to eat a varied and balanced diet to keep their blood glucose levels stable and enhance their immune system. It is recommended to:
In response to the COVID-19 pandemic, governments in many countries have restricted the movement of their citizens, confining them to the home environment. Regular physical activity is of great benefit to the general population and even more for people living with diabetes. View a series of daily exercises that can be performed at home.
In some countries, restrictions imposed to tackle the spread of the COVID-19 pandemic are disrupting the supply chain for insulin and other essential diabetes medicines. IDF is actively monitoring where issues are arising and helping to determine what assistance can be offered. Learn more.
IDF has also joined a global effort, together with the world’s leading diabetes organizations, to reduce risk for people with diabetes during the COVID-19 pandemic. Learn more.
COVID-19 is a new coronavirus. Keep informed of the latest developments by looking out for updates and advice from your government, national diabetes association and other reliable sources.
Several IDF national members have published guidance and advice on managing and preventing COVID-19 for people with diabetes and health professionals in their countries. A selection of links is available below.
Argentina: CUI.D.AR; FAD | Australia | Bangladesh - Guidelines for people with diabetes (Bangla) - Guidelines for HCPs | Belgium - Dutch; French | Brazil - ANAD; SBD | Costa Rica | France | Germany | Greece - EDE; HDA Guidelines | India; Interview with Chair, IDF South-East Asia Region (Hindi) | Iran | Italy | Japan | Mexico | Morocco (pdf) | New Zealand | Poland | Portugal; APDP webinar 6 April 2020 (YouTube) | Slovenia | Spain | Sweden | Turkey | USA - ADA; JDRF
IDF's official journal, Diabetes Research and Clinical Practice (DRCP), is committed to playing a positive role during the COVID-19 crisis. It aims to serve as a quick, trusted and authoritative platform for disseminating new diabetes research relating to the pandemic, with the aim of better serving people with diabetes all around the world. Articles currently published on the topic include:
Type 2 diabetes is the most common type of diabetes, accounting for around 90% of all diabetes.
It is generally characterized by insulin resistance, where the body does not fully respond to insulin. Because insulin cannot work properly, blood glucose levels keep rising, releasing more insulin. For some people with type 2 diabetes this can eventually exhaust the pancreas, resulting in the body producing less and less insulin, causing even higher blood sugar levels (hyperglycaemia).
Type 2 diabetes is most commonly diagnosed in older adults, but is increasingly seen in children, adolescents and younger adults due to rising levels of obesity, physical inactivity and poor diet.
The cornerstone of type 2 diabetes management is a healthy diet, increased physical activity and maintaining a healthy body weight. Oral medication and insulin are also frequently prescribed to help control blood glucose levels.
Several risk factors have been associated with type 2 diabetes and include:
*Impaired glucose tolerance (IGT) is a category of higher than normal blood glucose, but below the threshold for diagnosing diabetes.
Changes in diet and physical activity related to rapid development and urbanisation have led to sharp increases in the numbers of people living with type 2 diabetes.
The symptoms of type 2 diabetes are similar to those for type 1 diabetes and include:
These symptoms can be mild or absent and so people with type 2 diabetes may live several years with the condition before being diagnosed.
The cornerstone of managing type 2 diabetes is a healthy lifestyle, which includes a healthy diet, regular physical activity, not smoking, and maintaining a healthy body weight.
Over time, a healthy lifestyle may not be enough to keep blood glucose levels under control and people with type 2 diabetes may need to take oral medication. If treatment with a single medication is not sufficient, combination therapy options may be prescribed.
When oral medication is not sufficient to control blood glucose levels, people with type 2 diabetes may require insulin injections.
The most commonly used oral medications for type 2 diabetes include:
There are a number of factors that influence the development of type 2 diabetes. The most influential are lifestyle behaviours commonly associated with urbanisation. Consistent evidence shows that type 2 diabetes can be prevented by relatively modest intentional weight loss, which can be achieved through healthy diet and regular physical activity. A healthy diet includes reducing the amount of calories if you are overweight, replacing saturated fats (eg. cream, cheese, butter) with unsaturated fats (eg. avocado, nuts, olive and vegetable oils), eating dietary fibre (eg. fruit, vegetables, whole grains), and avoiding tobacco use, excessive alcohol and added sugar.
Regular physical activity is essential to help keep blood glucose levels under control. It is most effective when it includes a combination of both aerobic (eg. jogging, swimming, cycling) exercise and resistance training, as well as reducing the amount of time spent being inactive.
Brief questionnaires are simple, practical and inexpensive ways to quickly identify people who may be at a higher risk of type 2 diabetes and who need to have their level of risk further investigated.
The Finnish Type 2 Diabetes Risk Assessment Form, developed in 2001, is an example of an effective questionnaire that can be used as the basis for developing national questionnaires which take into account local factors. It has eight scored questions, with the total test score providing a measure of the probability of developing type 2 diabetes over the following 10 years. The reverse of the form contains brief advice on what the respondent can do to lower their risk of developing the disease, and whether they should seek advice or have a clinical examination. The test takes only a couple of minutes to complete and can be done online, in pharmacies or at various public campaign events.
IDF has developed a type 2 diabetes online diabetes risk assessment that aims to predict an individual’s risk of developing type 2 diabetes within the next ten years. The test is based on the Finnish Diabetes Risk Score (FINDRISC) developed and designed by Adj. Prof Jaana Lindstrom and Prof. Jaakko Tuomilehto from the National Institute for Health and Welfare, Helsinki, Finland.