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Sugar Surfing™ in the post Covid-19 era

Many questions get sent to me regarding living and managing type 1 diabetes in the Covid-19 'new reality'.

I will preface this by saying I am no Dr. Fauci, but I’ve appreciated reading about how he lives and the safety principles he follows. I'm a pediatric endocrinologist and not an expert in infectious diseases. But like Fauci (due to his age), I’m considered 'high risk' for Covid-19 consequences. I’m over 60, have had type 1 diabetes 55 years, have hypertension and coronary artery disease (the latter two well treated). I am not overweight (150 pounds, 70 inches tall).

My patients and families often ask me "what do you do, given your long history of type 1 diabetes"? I wanted to summarize here the choices I've made. Hopefully they will be reinforcing of the choices you are already making or considering.

First, I Sugar Surf. That just means I manage my blood sugar very carefully using my knowledge, wits and experience. My continuous glucose monitoring (CGM) device gives me the information I need to make the best self care choices I can make “in the moment”. I also use multiple dose insulin therapy now, not an insulin pump. But those devices are wonderful tools I prescribe regularly for patients. This page and my book are full of information and methods to better manage type 1 diabetes, with or without a CGM.

Lately, I've read inspiring accounts of fellow type 1 individuals who have effectively Sugar Surfed their way through a Covid-19 infection using their self care skills and CGM.

As above, my hypertension has been well controlled for decades as has my coronary artery disease. I exercise daily (5 mile walks). I use an ACE inhibitor to manage my hypertension. I see no reason to change that. Recently published studies now support continued ACE or ARB use. Untreated high blood pressure is much more riskier should Covid-19 strike you.

Avoiding as much junk and processed foods as possible is also something I consider part of my Covid-19 defense strategy.

I aim to take the same precautions that most of you (hopefully) do already. These are not listed in order of importance.

  1. Wear a comfortable fitting face mask when out in crowds or with my patients.

  2. Avoid touching surfaces unnecessarily. Use disposable gloves as needed.

  3. Become adept at using my knuckles, wrists, elbows, back (and butt) to open doors, press buttons (or give an occasional elbow bump).

  4. Carry hand sanitizer with me everywhere I go. Use it often.

  5. Aim to keep my hands off my face as much as possible. (not easy)

  6. Wash my hands frequently with soap and water. (as a doc, I did this a lot already)

  7. Eat at home mostly, but I we get take out food from time to time. We dine out very selectively and carefully.

  8. Exercise daily, get outside into the sunlight.

  9. Get a good night’s sleep.

  10. Avoid crowded places as much as possible. SOCIAL DISTANCING

Stress and fear of the unknown are our greatest obstacles in the new normal era. Maintaining regular contact with friends and family is invaluable. Videoconferencing has become a new window to the world, whether for work or for family. Maintaining contact with others helps with the sense of uncertainty this situation creates for all of us. I am no different.

No preventative measures are perfect, short of living in an underground bunker the next couple years. What you've read in this short post hopefully tells you that it's possible to do "what the experts do" to mitigate the risks of getting Covid-19 and still live your life to its fullest. Our greatest challange is (and will continue to be) sticking with what works. Remember: patience is a virtue in Sugar Surfing!


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