These times with the coronavirus

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My neighborhood is a ghost town. Who could have imagined three weeks ago New York City is shutting down?

I imagine like me you’ve read a ton of articles about the coronavirus. Some say having diabetes puts you at greater risk, others say if your blood sugar is well managed and you don’t have comorbidities like heart disease and high blood pressure you’re at no more risk than anyone else. Who knows? But I thought I’d pass on an article from diaTribe for general diabetes coronavirus info.

Below is an email I received from Nurse Specialist/CDE Carolyn Robertson: 

What are the facts?
Diabetes is a chronic disease, If you have Type 1 diabetes, it was caused when the immune system mistook the beta cells as a foreign invader.  That response ramped up your the system and it destroyed what it perceived as a threat.   Having diabetes does not mean you are immunocompromised.   It means you are hormone deficient. 
 
Are you more at risk ? 
Per se, you are not inherently more vulnerable to the virus. However, that statement assumes that your glucose control is mostly good and you do not have other medical problems.  The diabetes makes you more vulnerable when your blood sugars are increased or if your blood sugars are fluctuating with wide swings.   Values over 180mg are associated with a change in the body’s ability to  identify infection and it’s ability to fight infection. The higher the blood sugars the more the system is affected.   It is vitally important that you aim to manage the diabetes so that you get 70% of your daily values below 180mg.  Achieving that level of success would be awesome and it will reduce your risks.   
 
What should you do?  
Try to maximize the effectiveness of your insulin. 
  •  Bolus for all carbs and bolus  before eating.  If you take rapid insulin ( humalog, novolog, aphidra), give it time to work before you start eating. 
  • Rapid acting insulin takes 15 min to start to work. So by delaying a meal or snack by 15min, it means that when you start the meal, the insulin will be also starting 
Consider verifying that carbohydrate counting skills are good.  
  • Use an app like Calorie King to look up the carb value of the items you eat. 
  • Weigh  and measure your carbohydrate portions for a few days. .  
Consider using activity to help the insulin be more effective.  The gyms might be closed but you can still walk. 
  •  Walking, while it doesn’t burn as many calories, has a profound effect in mobilizing glucose.  Some people have found that walking drops the blood sugar levels more than a workout.    
Use your support system.  Don’t isolate yourself.  Skype,  Face Time and  phone calls can keep you connected even while you social  distance. 
  
Consider using telemedicine to get help with your diabetes management.  Many centers are making this an option – including UCLA and Mt Sinai.  I have been doing Telemedicine with many of you for years and I plan to continue to offer this as an option to all my patients.  I am still available to you.   If you want to schedule a visit,  let me know.   We can do a phone/Skype call. I am in AZ so my time zone is the same as California  and 3  hrs earlier than NY. 
 
This is a unique and unprecedented challenge for our country, but with our resilience, innovation, resolve, and unity, we will prevail.  
 
With warm regards
Carol 

In my reading, this article covers a topic few have: how to maintain a low carb diet if vegetables become scarce. While others are loading up on pasta and rice following low carb these aren’t very desirable options. But, if we will need to eat more of these foods, here’s are two tips: 1) basmati rice has the lowest carb count of any rice. 2) If you cook any rice in twice as much water, for instance eight cups of water rather than four for one cup of rice, more starch will exit the rice and go into the water, therefore there’ll be less carbs in your rice.  Worth a try.

As to life going on, it’s a most bizarre time. I take a walk in my neighborhood every day just to move, do my qigong every morning, am baking a lot of low carb goodies like Keto rolls and chia seed almond scones – you can find a ton of recipes online – and googling how to freeze fish and chicken now that I have supplies for two weeks.

I have a number of books on my kindle, many about North Korea, a personal fascination, and I’ve just started watching The Valhalla Murders on Netflix. Not great, but anything that takes me to another country right now is welcome. A few Netflix and Amazon Prime programs that I do recommend:

Netflix:

The Crown, Shtisel, Bordertown, Trapped, Breaking Bad, Fauda, The Cakemaker

Amazon Prime:

Scott & Bailey, Silent Witness, Fleabag, Criminal, The Baker and the Beauty

Stay safe, wash your hands and keep breathing. Or as the Brits probably are already making a new T-shirt, “Keep calm and carry hand sanitizer.”

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