Can diabetes increase the severity of dengue? Can the mosquito-borne illness impact your blood sugar levels?

Dengue cases in Delhi have seen a spike with 635 new infections being reported in the first 12 days of October. The total tally now stands at 1,572 so far this year, a civic body report said

The number of dengue cases reported in Delhi has seen a spike with 635 new infections in the first 12 days of October. According to a civic body report, the yearly tally now stands at 1,572. It added that of the total cases, 693 were reported in September alone. With the rise in cases of this viral illness, spread to people through the bite of an infected Aedes species mosquito, it is crucial to follow certain safety precautions, especially if you are a diabetic.

This is because diabetics are more at risk as “in case of dengue in a diabetic patient, the inflammatory markers spike since they already have immunosuppressive markers,” according to Dr Santosh Pandey, Acupuncture and Naturopathy Specialist, Founder and CEO, Dr Santosh Healthcare Centre, Mumbai.

Dr Vaishali Pathak, Diabetologist and General Physician, Cardiomet Clinic, Pune asserts that while diabetics are not at more risk of dengue as mosquitos do not discriminate between a diabetic and a non-diabetic, “they should be more careful to avoid getting dengue fever as diabetes increases the risk of complications”.

Explaining the reason diabetes can increase the severity of dengue in patients, Dr Pathak explained, “Diabetes increases severity of thrombocytopenia, that is low platelet count, in dengue infected patients. Hyperglycemia (high blood sugar) contributes to greater platelet reactivity through direct effects and by promoting glycation of platelet proteins.”

She added that diabetes mellitus results in weak immunity and fragile blood vessels that, in turn, lead to a higher risk of bleeding. “Sometimes, steroid usage in dengue can lead to an increase in blood sugar levels, leading to more complications,” she added.

World Health Organisation (WHO), too, mentions that diabetics are at a higher risk of developing complications of dengue, such as Dengue Hemorrhagic Fever (DHF), Dengue Shock Syndrome (DSS) and Severe Dengue (SD). “Other groups at high risk include pregnant women, menstruating females, and patients with haematological diseases,” Dr Hina Mehra, Senior Consultant, Internal Medicine, Apollo Hospitals, Bannerghatta, Bangalore added.

Additionally, experts highlighted that dengue also affects one’s blood sugar levels. This is because “the sugar levels of patients by default are already more because of the inflammation, leading to an increase in blood sugar levels,” Dr Pandey said.

Agreeing, Dr Pathak added that dengue fever is characterised by an increase in metabolic rate, which can lead to fluctuations in blood sugar levels. “If not monitored properly, there is a high risk of such patients developing serious complications. Plus at a few incidences, the use of steroids in view of increasing platelet count may give rise to very high sugars which can cause complications like diabetic ketoacidosis, fungal infections and chest infections,” she said.

Not just in diabetics, dengue tends to increase blood sugar levels even in non-diabetics and prediabetics, Dr Mehra said. “Special care is to be taken to monitor and control blood sugars during dengue infection.”

What should diabetics do in case of dengue?

It is crucial to check blood sugar levels at regular intervals, experts said. “If found high, consult a doctor,” Dr Pathak suggested.

Further, emphasising the need for proper hydration, she explained that in dengue, the capillary permeability increases, leading to low blood pressure. “So proper hydration is necessary. At least 3 litres of fluids must be consumed daily.”