Vaccine

Diabetes is not a contraindication for COVID vaccination. You can safely take it if there are no other contraindications. The other contraindications are - 

  • History of anaphylactic reaction of delayed hypersentivity in past
  • Bleeding or clotting disorders
  • Recent history of COVID or COVID like symptoms
  • Acute sickness
  • Pregnant and lactating mothers. 

Both vaccines are equally good and you should go for whichever is easily available. There were early reports of rare possibility of clots with COVISHIELD and that is why it is contraindicated in patients with history of clotting disorders. 

Sugar Control 

Poor glycemic control increases risk of infections and complications. All diabetic patients must maintain a good glycemic control to prevent such complications. You should monitor your sugar levels more frequently, have plenty of fluids and follow up with your doctor for changes in medications if needed. 

Steroid use

Steroid are kown to cause sugar spikes. A lot of diabetic patients suffering from COVID 19 are being prescribed steroids leading to very high blood glucose levels. Steroid should be used judiciously only if prescribed by a doctor. During this period many of the patients need to be put on insulin injections to control their sugar levels. Insulin is not a habit forming drug and use of inuslin during this period does not make you dependent on insulin for life. 

Insulin dose adjustment

There are several types of insulin. The common ones being 

  • Short or rapid acting - it acts for 4-6 hrs only and is used before meals to control post meal spikes or to bring down very high sugar levels 
  • Long acting - These insulins act for a duration of 16 - 48 hrs and are used to bring down high fasting sugar levels. 
  • Premixed insulin - these are mixtures of the short and long acting insulins are and are prescribed two times a day

If you can not get help from your doctor you may take help of this guide. 

  • Adjust the dose of long acting insulin to target fasting sugar. You may increase or decrease the dose by 2U at a time. 
  • Adjust the dose of short acting insulin to target the post meal sugars. If day time sugar levels are very high then you may use a sliding scale and decide the dose based on premeal sugar value. 
  • Adjust the morning dose of premixed insulin to control daytime sugars while to control post dinner and fasting sugar adjust the dose of night time insulin.