India's big health issue of obesity: Proportion of overweight men doubled in 10 years

Between 30-40 per cent of deaths from studies in intensive care units from different countries are people with diabetes, said Paul Zimmet, Professor of Diabetes, Monash University, Australia.

Zimmet, who is President International Diabetes Federation, added that the actual mechanism as to why COVID-19 may cause diabetes is as yet unknown, however, several possibilities exist. "COVID-19 is a very destructive and cunning virus and causes terrible damage to tissues including the lungs and pancreas," said Zimmet. Below are excerpts from an exclusive chat with IANS.

Why do you say Diabetes is dynamite if a person has been infected with COVID-19?

There have been many deaths in many countries, e.g. Italy, China, the UK and US among people with diabetes after infection with COVID-19 (SARS-Cov-2).

The mortality tends to be mainly in older Type 2 diabetics. Between 30-40 per cent of deaths from studies in intensive care units from different countries are people with diabetes. This outcome and other complications from the virus, particularly pneumonia, are more likely in people with diabetes which is poorly controlled with high blood sugars (poor metabolic control).

Diabetes is often associated with other chronic conditions, including obesity, hypertension and heart disease compounding the risk. These latter conditions all convey higher risk to COVID-19 infections.

ACE-2, which binds to SARS-Cov-2 and allows the virus to enter human cells is also located in organs and tissues involved in glucose metabolism. Is there solid evidence that virus after entering tissues may cause multiple and complex impairment of glucose metabolism?

The actual mechanism as to why COVID-19 may cause diabetes is as yet unknown.

However, several possibilities exist. Firstly, COVID-19 is a very destructive and cunning virus and causes terrible damage to tissues, including the lungs and pancreas.

A new study just published showed that in miniature lab-grown pancreas, and other cells such as liver, made using human stem cells, COVID-19 caused destruction of the pancreas beta cells that produce insulin.

It is possible that the virus causes disruption of the cells by disrupting cellular metabolism. This is possibly the way it brings about new-onset diabetes. ACE-2 exists in high concentration in the lung as this also explains the terrible lung side effects of COVID-19 infections.

Can COVID-19 lead to a new mechanism of diabetes? Probably a new form of diabetes or a new form of disease?

The COVID-19 virus has only been with us for about 5 months and there is a huge amount that we still must learn about its cunning and devastating ways. The purpose of the Global COVIDIAB Diabetes Registry, a joint initiative of Monash University in Australia, and King’s College London is to gain a much better understanding of how common is the appearance of COVID-19 related diabetes, what form does it take be it type 1 or type 2 or a new form, and how common are the complications that we already know e.g. diabetic keto-acidosis, hyperosmolar coma and high insulin requirements are causing high rates of ill health and mortality worldwide. The knowledge gained will aid our understanding for developing strategies to prevent and treat this terrible virus that has caused destruction globally.

Diabetes is one of the most prevalent chronic diseases in India. According to a recent study, sugar levels of diabetic persons increased by 20 per cent during nationwide lockdown in India to contain COVID-19 outbreak. Even after lockdown was lifted, many people are confined within their home. Do you think lack of physical activity will create more problems for diabetics?

My own major research has been on studying populations with high rates of diabetes, including ethnic Indian communities including India, Mauritius, and Fiji so I am very well aware of this. It is now well established that along with diabetes, that associated poor metabolic control of their diabetes places these people at the highest risk for COVID infection and its devastating complications and the associated morbidity and mortality. And these communities have high prevalence of heart disease as well.

Lockdown not only has deleterious effects on metabolic control of the diabetes through reduced opportunities for exercise to be protective serious consequences of SARS-CoV-2 infection, lockdown usually results in disruption of the regular medical care and the regular monitoring of metabolic control. This may also be partly due to the stress and poor compliance, or inability to afford their medications such as insulin. It may also be compounded by inability to access the care during the pandemic. Nevertheless, we now know that poor metabolic control heightens their risk as described above.

You have said diabetes is itself a pandemic just like Covid-19, and the two pandemics could be clashing. How could governments address this problem?

These are “The Times of COVID-19”. Most nations of the world were totally unprepared for a pandemic of this magnitude. They underestimated its potential impact and the destructive nature of the viral infection. This should prompt all countries to upgrade their guidelines to take into account the lessons learnt on infection control including training of staff specialising in infectious diseases and improved public education and taking their communities into their confidence about the terrible nature of COVID-19. The risks of COVID-19 infection need a much higher priority in the general community, particularly for people with chronic conditions such as diabetes, obesity, and cardiac conditions.

Governments are faced with chronic diseases (NCDs) like diabetes and communicable diseases (CDs) like viral and enteric diseases and TB. In general WHO gives the highest priority to communicable diseases and much less attention and funding to chronic diseases like diabetes (I was an adviser to WHO for many years (about 30) on diabetes and obesity and it was very frustrating to deal with this situation).

This attitude to diabetes, for example, has a flow down effect so that diabetes funding in countries by governments, rich and poor, suffered and was insufficient.

So now we have a COVID-19 pandemic and who are those at highest risk, yes people with diabetes and other NCDs, it is very important that now the two, Diabetes and COVID-19 are clashing face-to-face. This is a major issue that WHO and national governments have to face with equal priority’

Stressed people suffering from diabetes run a greater risk of poor blood glucose levels, what do you suggest to these people?

As mentioned in the answer above, stress is an important factor in upsetting the blood sugar (metabolic) control of diabetes. Additive to this is poor compliance with medications and diet. These and potential associated comorbidities due to other chronic conditions are part of the dynamic dynamite mixture.

New York, May 19: Cigarette smoke spurs the lungs to make more of the receptor protein which the novel coronavirus uses to enter human cells, according to a study which suggests that quitting smoking might reduce the risk of a severe coronavirus infection.

The findings, published in the journal Developmental Cell, may explain why smokers appear to be particularly vulnerable to severe COVID-19 disease.

"Our results provide a clue as to why smokers who develop COVID-19 tend to have poor clinical outcomes," said study senior author Jason Sheltzer, a cancer geneticist at Cold Spring Harbor Laboratory in the US.

"We found that smoking caused a significant increase in the expression of ACE2, the protein that SARS-CoV-2 uses to enter human cells," Sheltzer said.

According to the scientists, quitting smoking might reduce the risk of a severe coronavirus infection.

They said most individuals infected with the virus suffer only mild illness, if they experience any at all.

However, some require intensive care when the sometimes-fatal virus attacks, the researchers said.

In particular, they said three groups have been significantly more likely than others to develop severe illness -- men, the elderly, and smokers.

Turning to previously published data for possible explanations for these disparities, the scientists assessed if vulnerable groups share some key features related to the human proteins that the coronavirus relies on for infection.

First, they said, they focused on comparing gene activity in the lungs across different ages, between the sexes, and between smokers and nonsmokers.

The scientists said both mice that had been exposed to smoke in a laboratory, and humans who were current smokers had significant upregulation of ACE2.

According to Sheltzer, smokers produced 30-55 per cent more ACE2 than their non-smoking counterparts.

While the researchers found no evidence that age or sex impacts ACE2 levels in the lungs, they said the influence of smoke exposure was surprisingly strong.

However, they said, the change seemed to be temporary.

According to the data, the level of the receptors ACE2 in the lungs of people who had quit smoking was similar to that of non-smokers.

The study noted that the most prolific producers of ACE2 in the airways are mucus-producing cells called goblet cells.

Smoking is known to increase the prevalence of such cells, the scientists said.

"Goblet cells produce mucous to protect the respiratory tract from inhaled irritants. Thus, the increased expression of ACE2 in smokers' lungs could be a byproduct of smoking-induced secretory cell hyperplasia," Sheltzer explained.

However, Sheltzer said other studies on the effects of cigarette smoke have shown mixed results.

"Cigarette smoke contains hundreds of different chemicals. It's possible that certain ingredients like nicotine have a different effect than whole smoke does," he said.

The researchers cautioned that the actual ACE2 protein may be regulated in ways not addressed in the current study.

"One could imagine that having more cells that express ACE2 could make it easier for SARS-CoV-2 to spread in someone's lungs, but there is still a lot more we need to explore," Sheltzer said.

An uncertain prognosis, severe shortage of resources and the imposition of unfamiliar public health measures that infringe on personal freedoms along with large and growing financial losses are undoubtedly contributing to the widespread psychological and emotional distress associated with COVID-19.

The COVID-19 pandemic has forced millions of people to work from home world-wide. Today, due to constant exposure to increasing numbers, an intense fear of contamination have a massive psychological impact on people who are working from home.

Kuhoo Gupta, Healer and Founder of The K Junction talks about wellness during work from home as the situation is resulting in people being vulnerable to severe mental illnesses. Staying positive and optimistic while working from home during pandemic can be heavily challenging.

Gupta states its critical to maintain your mental well-being and immune system, as people with mental upheavals are prone and susceptible to various flu or inflammations. Your bodies immune system reacts abnormally which diminishes the capability of it's function.

The only key to manifesting a wonderful well-being is to try and calm one's mind and focus on constructive and wellness activities, to find a path towards making ourselves more resilient while working from home. Gupta shares 5 tips you can start doing today to improve and enhance your positive outlook.

Remember! Your workplace should be a sacred space where you are able to find a sense of comfort in your work environment. It should help you feel positive, healthier and happier, more like a protective zone.

Fabricating a Positive Workstation

There should be a separate workstation so that one can concentrate while working from home. It would be great if the work desk is stationed somewhere near a window or a balcony door so that one can welcome sunlight, fresh air and a view of plants & birds during the day. Try to have an ergonomic setting of your table and chair so that you keep your posture right while working the whole day. Keeping one or two indoor plants near your work desk will help to make it interesting.

Keep your laptop charger wires and other stuff neatly on your desk to avoid overwhelming yourself. Motivation quotes around you will help to make you overall positive. Keep your notes diary and pen handy at your desk. It will always helps to keep some colorful artifacts around you to make the atmosphere a little cheerful.

Declutter Your Workstation

Avoid the pilling up files and unnecessary stationery at your workstation. Clutter is responsible for the confusion and problems all around and it leads to distraction; thus, a clean desk reflects power which enhances positivity and creates a tranquil workspace that will help your mind focus on productivity. It is important to declutter your work desk once in a few days because physical clutter translates to mental clutter.

Gratitude Notes in workstation and how to manifest

It is a great morning practice to write at least five things you are grateful for. It helps to shift the focus from negative to positive, from scarcity to abundance. One can write gratitude statements on Post it notes and put them at the work daily. This will raise the vibrations and help you stay grounded and positive. You can also compile affirmations and prayers that you resonate. Whenever you take work breaks, it is a good idea to read these.

Crystals to imbibe positivity at workstation

Selenite is a great crystal to spread light and positivity around. Black tourmaline absorbs negativity and is great to shield you from it during lockdown. Shungite is a great crystal to reduce the effects of electromagnetic radiations around you. You can place it near your wifi router, laptop and other devices to reduce the EMF pollution effects on you and your family. Clear quartz is great for energizing you after a tiring meeting. Just hold it in your left hand with eyes closed for five minutes and visualise beautiful energy entering your body and soul.

You can combine this exercise by holding black tourmaline in your right hand and visualize all the tiredness and unwanted energy draining into the black tourmaline. Tiger eye is very effective in eliminating the scattered brain and it allows us to make confident decisions. Green Aventurine neutralizes stress and anxiety from work, allowing us to keep calm.

Lepidolite is known as the Peace Stone, making it one of the best crystals for peace. It improves our overall mood, calms us, soothes us, and reduces our anxiety with a peaceful sense of happiness.

Sodalite is a great crystal for peace because it turns fear and stress into peaceful feelings. It also helps in better communication and can help while making crucial presentations & meetings.

Fluorite is great for healing and rejuvenating the mind and body. You can close your eyes and sit quietly with Fluorite while imagining your body being filled with an incredible energy that puts you at ease with yourself and the world.

Pyrite, also known as abundance stone, is great to put over your business card to manifest abundance at work.

Don't forget to clean your crystals regularly to harness their maximum energy.

Meditate, Do Pranayam and Stay Hydrated!

It is important to take short breaks to maintain productivity at work. Being summer, it is a good idea to get up for a water break once in 30 minutes at least. Even if you keep a water bottle alongside you, walking to the kitchen for water will help your physical body get some much needed movement.

Few iterations of square breathing once in two hours is a great way to boost your mind and body. Square breathing is basically the sequence of inhalation - holding breath - exhalation - holding breath - all for equal time spans. So you can count mentally 1 to 4 in inhalations, then again counting 1 to 4 as you hold your breath, and so on and so forth.

You can also chant any mantra while taking a work break for 1 or 2 minutes. While attending online meetings, where there is nothing much your hands are doing, you can utilize that time to do Yoga Hast/Hand Mudras and harness their energies. Pran Mudra is one of the best options to practice while attending meetings or reading articles, where your hands are free essentially.

You can Also -

Dress up like you would do while going to office so as to feel good in general

Go out on your terrace/balcony once or twice a day to get some fresh air, sunlight and hear birds chirping

Say yes to distractions rather than getting irritated from them, because you cannot avoid them while working from home, like the kids, TV sounds, kitchen sounds etc.