Living with diabetes has proven stressful during this COVID19 pandemic. The media and medical community have made it very clear that having diabetes is a significant risk factor if you become infected. However, as restrictions are lifted, new worries come to light causing more confusion, worry, and fear. And not without just cause. There are many facets to the issue and no clear perfect answer (but if you know me, I don’t believe perfect exists anyway!)
“Is it safe?”
As people head back to work, into restaurants, and book appointments at hair salons, we ask ourselves “Is it safe?” My answer is quite simply, NO. Unless you have been tested and know you have antibodies, you are just as vulnerable to infection as you were 2 months ago. And possibly even more so now.
Quarantining only prevents person to person spread of infection. This has reduced the number of infected people and as a result lowered the number of transmissions of the virus. It has allowed time for the medical community and suppliers to prepare staff and facilities, create protocols, and better understand what it takes to battle this virus. When we start venturing out, we will see more transmission of virus to susceptible people (that is most of us).
Our time in isolation may leave us with an immune system in idle. Typically, our immune systems constantly react to the ever-changing environment of our daily lives. Releasing antibodies, white blood cells and a million other small actions to battle the pathogens we encounter. Without this exposure, our immunity may be left with less to do and our “immune engines” running at a slower pace.
I quick side note, besides the first 3 months I worked in the ER, I was never healthier than during those year at the bedside. As I was daily exposed to any number of “germs”, I hardly ever got sick. Maybe once or twice a year. (OK – there was the weird virus that may have triggered my diabetes, but that was not the norm). Years later when I worked in a corporate office with a lot of healthy people, I seemed to catch any bug that was going around. In the ER my immune system was firing on all cylinders, in the office I never got out of first gear.
There are several other factors that can inhibit your immune system: stress, being less active, eating less healthy, drinking alcohol, isolation, fear, worry and basically any negative emotion. Sound a bit like quarantine? For many people, this change in lifestyle included unhealthy habits that weaken our immunity. It is possible that while staying at home prevents person-to-person transmission, it may slow down our best defense against the virus
“Is it necessary?”
So, should we be creeping back into society? Is it necessary? My answer is YES. As stated above, being isolated for long periods of time has its downside. The human animal was not meant to live in isolation nor without purpose. Our psyche and our immune systems need interaction.
In addition, we may just be moving illness and death (morbidity and mortality) to a different population. The stress of economic strife, destruction of earning potential, job loss, and failing business also lead to problems. I first heard about it in nursing groups and now we are hearing it in the news. Hospitals are seeing higher numbers of psych patients, child & spousal abuse cases, alcohol related ER visits, suicidal ideation and suicide attempts. I’m hearing anecdotal reports of more CPR presenting to the ER as patients avoid seeking treatment until it is too late. A studies indicate a significant lower number of life saving procedures for heart attacks due to patients avoiding hospitals. While some people are protected from COVID because of isolation measures, others are paying the price in other ways. It is badness any way you slice it.
We are also a consumer driven society, we need workers to produce food, process clean water, make our clothing, and manufacture innumerable goods that we all use. Including medication, glucose meters and test strips, pump supplies and any number of other things that keep us all healthy and fit. Although these are essential services, a failing economy is not sustainable to maintain our standard of living and health. Government money will only last so long. We need an active society to florish and prosper.
Emotionally people need to be productive as well. It feels good to contribute, create, produce, and pursue our passions. It’s healthy. So, there are good reasons to get back to work. Yet we need to figure out how to do this in the safest and most prudent way possible. Unfortunately, there is no one size fits all and no one to protect us completely. We bear the burden of our own safety.
Common sense and traditional diabetes education dictates that better glycemic control yields fewer complications and more favorable recover in the case of any illness or injury. The closer we stay to “normal” glucose levels, the less our bodies have to compensate. Studies demonstrate this holds true with COVID19 infections. This recent study found that an A1c around 7 or lower had more favorable outcomes that A1C in the 8-10 range. This study analyzed type 2 patients, but logically tight control is better for all people with diabetes.
Stress has also been shown to drive correlate to less than optimal glycemic control. Whether it is from emotional stress such as worry and fear, or physical stress from infection or injury, when under duress it takes more effort and diligence to stay in range.
It’s my personal belief that lack of education is not to blame for falling off the “diabetes wagon”. We all know that diet, exercise, medication and diligent monitoring of glucose levels are the key to tight control. But that is easier said than done – especially when times are tough and the future is uncertain. What we lack are coping skills, new motivation, emotional support and guidance on how to navigate change. Investing in yourself with some new tools can have big payoffs during these stressful times.
While this may appear simple (some of the best tools are the easiest), getting quiet can give you a whole lot of answers. Things like sitting outside and appreciating nature, meditating, praying, day dreaming, a bubble bath, or taking a walk can all help turn off your “worry brain”. Just find something pleasant to focus on for 10-15 minutes. It may seem like you are doing “nothing”, but you are actually doing a lot!
First your body needs balance. Worry zaps your energy. Peaceful moments can fill you back up. Second, this peaceful state boosts your immune system. When you are calm, you ignite your “rest and restore” system which includes your immune system. Third, when you tune out the chatter in your mind, you can tune in to your very wise intuition. It’s that quiet voice inside that whispers to you and knows what you need.
It may take a few practice sessions to figure out how to let go. Three or four deep breaths are a good start. Then simply ask yourself a question and then get quiet for a moment and consider your thoughts. Ask your wise intuition things like “What do I need right now to feel better?”, “How can I stay on my diabetes plan with more ease?”. “What is keeping me from my best?”. Then relax your shoulders, unclench your jaw and feel your blood flowing through your body. Something just might bubble up that surprises you!
As our society opens back up, each of us will find different levels of comfort and different ways to negotiate this uncharted territory. Tune into your inner wisdom and trust that it will guide you.
You got this! To peace and good health!