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How to Prevent or Reverse Diabetes, Including after a COVID-19 Infection

An endocrinologist and family medicine specialist explain how diabetes can be triggered as an immune response to COVID-19 and what you can do to ward it off.

Since the start of the pandemic, we’ve seen an uptick in new diabetes diagnoses across the nation. Research published earlier this year by the Centers for Disease Control and Prevention (CDC) indicates that people with diabetes are at higher risk of experiencing a severe COVID-19 infection, and that COVID-19 may be behind the worsening of diabetes symptoms and new diabetes diagnoses.

This has to do with how infections like COVID-19 can affect your blood sugar levels. Family medicine physician, Dr. Karen Dong, and endocrinologist Dr. Serge Jabbour answer our questions and discuss diabetes prevention, treatment and its link to COVID-19.

Am I at risk for diabetes or prediabetes?

Type 1, type 2 and prediabetes are all unique conditions with different risk factors. Type 1 diabetes, an autoimmune condition in which the pancreas produces little to no insulin, is typically diagnosed in adolescence but occurs in adults as well. Type 1 diabetes can be genetic, and unfortunately, there are currently no methods of preventing it.

People with prediabetes have higher than normal blood sugar levels, and this is often the precursor to type 2 diabetes. Prediabetes and type 2 diabetes are usually a result of aging and lifestyle factors, such as being overweight or sedentary.

How is diabetes diagnosed?

“Prediabetes and type 2 diabetes are often silent and diagnosed with a routine blood test,” says Dr. Jabbour. “Some patients with very high blood sugar may experience polyuria, or excessive urination; polydipsia, or excessive thirst; and blurred vision.”

If you are at risk for either prediabetes or type 2 diabetes, your provider can order an A1C test—a blood test that measures your average blood sugar levels over the past three months. According to the CDC, normal A1C levels are below 5.7%. Anything ranging between 5.7 and 6.4% indicates prediabetes, and anything higher than 6.4% means you have diabetes. “You should have your blood sugar levels tested every year at your annual exam,” says Dr. Jabbour. “Blood sugar levels can change over the course of a few months, so regular check-ups are extremely important.”

Can diabetes or prediabetes be reversed? 

Fortunately, prediabetes can be reversed or stabilized and type 2 diabetes can be prevented with lifestyle changes, such as eating a balanced diet and exercising a few days a week. “We encourage our patients to start simple. Add some more nutrient-dense foods into your diet and go for a brisk walk a few days a week,” says Dr. Dong.

Dr. Dong also recommends that patients seek support, and work with trained medical professionals, such as a dietitian, to help make realistic and sustainable lifestyle changes. “It’s a very personalized process –as we all lead different lifestyles – and many patients can benefit from the support of their families and professionals to motivate them and stay consistent,” says Dr. Dong.

What is the link between COVID-19 and diabetes?

Just like any other infection, COVID-19 triggers immune responses, especially for people at risk for diabetes. “COVID-19 raises blood sugar as an immune response, so people with COVID-19 are more likely to receive a new diabetes diagnosis after infection than those without COVID or with other respiratory infections,” says Dr. Dong.

For many people at risk for diabetes, a COVID-19 infection will temporarily raise their blood sugar levels, then they will return to their prior levels after the infection calms down. “However, a severe infection of COVID-19 – especially a case that puts a patient in the hospital – may raise blood sugar levels enough to trigger a diabetes diagnosis six to twelve months after infection,” explains Dr. Jabbour.

Do at-risk or prediabetic people need to be more cautious when it comes to COVID-19?

If you are at risk for developing diabetes, you are more vulnerable to infections in general—COVID-19 or otherwise. High blood sugar levels can weaken the immune system and affect its ability to fight off infection. “After being sick, patients need to be extra careful and thoughtful about making healthy lifestyle choices in order to re-stabilize their blood sugar levels as quickly as possible to avoid a diabetes diagnosis,” says Dr. Jabbour.

Aside from diet and exercise, experts also recommend staying up-to-date on all recommended vaccinations and boosters to help support the immune system.

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