了解糖尿病和冠状病毒的危险组合

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虽然大多数人都对冠状病毒感到焦虑, 患有糖尿病等潜在疾病的人可能尤其如此.

在生活的日常需求之上, 与大流行有关的新菌株正在造成损失, 杰奎琳·阿里哈尼说, 她是洛杉矶居民，也是心脏健康倡导者志愿者. Alikhaani患有糖尿病, a serious congenital heart condition called anomalous origin of the right coronary artery, 以及其他慢性疾病.

她担心能否安全获得食物, 医学, 防护用品和其他用品, 家庭经济损失, 打理家务，照顾亲人. 自冠状病毒危机开始以来, 她也没睡好, 在获得药物补充方面有问题, recorded some high blood sugar readings and is consulting with her doctors about an increase in intermittent chest pain, 她认为这是压力造成的.

“这些天真的很可怕. I'm seeing that the risks are higher for people who have diabetes and heart disease,阿里哈尼说, 是谁在关注她的饮食, 锻炼, 监测她的血糖和血压, 让她的医生了解最新情况. “我正在努力学习更多, 了解并采取预防措施, 关注糖尿病和心脏健康需求, 并鼓励其他人也这样做."

截至3月底， 初步的数据 美国疾病控制与预防中心为大约7100名美国人提供了这项服务.S. 随着年龄的增长，冠状病毒患者也表现出这种情况, 各种健康状况——最常见的是糖尿病, chronic lung disease and heart disease — put patients at risk of developing severe viral illness.

特别是在COVID-19重症监护患者中，32%患有糖尿病. 在非ICU住院的COVID-19患者中，24%患有糖尿病. Yet for people with COVID-19 who did not require hospitalization, only 6% had diabetes.

早些时候，来自中国的更广泛的研究发表在 《线上娱乐电子游戏网站》 COVID-19患者的死亡率为2%. But this rate jumped to about 10% for those who also had cardiovascular disease and to about 7% among those with diabetes. A 意大利报道 在死于该病毒的481名患者中，约有三分之一患有糖尿病. That represents a risk of death five times higher than would be expected based on diabetes' overall prevalence in Italy, 博士说. Robert Eckel, an endocrinologist at the University of Colorado School of Medicine.

虽然关于COVID-19还有很多需要了解的地方, its course in people with diabetes appears to loosely parallel that of influenza. 结果不太稳定, 通常需要呼吸机, and severe complications are more likely in people with diabetes who get the flu, 埃克尔说, 现任美国糖尿病协会医学和科学主席.

原因很复杂. 在2型糖尿病患者中, 胰岛素抵抗引起慢性, 慢性炎症, 使免疫系统在这种持续的戒备状态下变得迟钝. New infections are like "crying wolf" — the immune system does not rally quickly and adequately, 因此让病毒获得并保持立足之地.

但流感不像COVID-19感染那么危险. 在COVID-19糖尿病患者中也是如此, 额外的风险因素，如心脏病, 有时未确诊的, 使问题复杂化, 埃克尔说, 他也是美国心脏协会的前任主席.

Doctors' experience with bacterial infections indicates that controlling blood sugar before and during infection can be helpful. 在危机期间, Eckel advises hospitalized COVID-19 patients who have diabetes to ensure their glucose is carefully managed — and to monitor it themselves, 他们有自己的供给, 如果他们有能力.

糖尿病并发症称为糖尿病酮症酸中毒, 或分析, 冠状病毒患者是否有其他病毒感染的风险, 他说. DKA occurs when an absolute or relative insulin deficiency prevents cells from using glucose for energy and they burn fat instead, 产生一种叫做酮的化学物质，这种化学物质会在血液中积聚，并且可能有毒.

在一次严重的感染中, 埃克尔说, diabetes drugs called SGLT2 inhibitors contribute to an increased risk f或分析. Patients with COVID-19 should talk to their doctor about stopping these medications at the time of hospitalization, 而且可能更快.

另一种糖尿病药物, 二甲双胍, 住院的冠状病毒患者也可能需要停止使用, 他说. 在极端情况下, 包括脱水和肾脏疾病, 二甲双胍 could foster acidosis and even exacerbate kidney disease when intravenous contrast agents are used in imaging.

在医院外面 ADA推荐 keeping blood sugar well controlled and consulting health care professionals about managing risk and any viral symptoms. If feeling very ill — including higher fever with cough and shortness of breath — people should seek emergency care.

"Patients with diabetes need to be alert about not delaying if they're getting sick, 尤其是在短线上电子游戏飞禽走兽内,埃克尔说.

Alikhaani是 用心了解糖尿病, a joint initiative of the AHA and ADA to reduce cardiovascular complications in people with Type 2 diabetes. 她相信最终会更多 COVID-19知识 会帮助公众避免感染和提高自我保健吗.

"People can partner with their doctors better when they understand more about the mechanics of what's going on,她说.

目前，Alikhaani主要依靠信仰、家庭和社区. S他说 when the crisis passes and everyday life resumes, there could be a silver lining. “也许等我们回去的时候, we'll see that we might not miss everything that right now we think we are missing."

Editor's note: Because of the rapidly evolving events surrounding the coronavirus, the facts and advice presented in this story may have changed since publication. 访问 心.org 获取最新报道, and check with the Centers for Disease Control and Prevention and local health officials for the most recent guidance.

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