Written by: Dr Miza Hiryanti binti Zakaria, Endocrinologist, Hospital Tengku Ampuan Afzan

Malaysia records total coronavirus infections over 600 000 and falls third in ASEAN behind Indonesia and the Philippines. Hitherto, more than 3k coronavirus-related deaths reported in the country since the pandemic began. Seven in ten people who succumbed to Covid-19 in Malaysia suffered from diabetes, according to National Institutes of Health (NIH). People with diabetes are 3 to 4 times more likely to develop serious COVID-19 disease than those who do not have diabetes¹. Nonetheless, those with stable blood sugar levels will have a better outcome compared to those with poor blood sugar control.

To win this war against COVID 19, several measures has been implemented. These include wearing protective mask, practising social distancing and above all achieving herd immunity. This occurs when a large number of the people in a community becomes immune to a disease, making the spread of disease from person to person is interrupted. The end result, not just the immune but everybody in community including the very young and the oldest of old become protected. This can only be achieved by vaccination.

Most vulnerable group, like people with diabetes, should be vaccinated as soon as possible. Vaccines are designed to programme the body’s immune system to safely recognize and block the virus that causes COVID-19. They prepare our body to combat future covid infection. When actual infection attacks us, our body will be geared up and ready to fight the virus.

People with diabetes should consult their health care provider before vaccination to help them to plan their sick day management plan. This would include how to manage the side effects should they come out, monitoring of blood sugar, adjustment of medications and when to seek out medical assistance. Full medical check-up before vaccination is unnecessary if they are already on regular follow up. Certain health facilities for example government hospitals and health clinics will provide their patients with pre vaccination assessment letter. This document will provide the necessary information to facilitate vaccination process in vaccination centre.

Following vaccination, as our body is producing antibodies and learning how to fight the virus targeted by the vaccine, we may experience some side effects. This is because our immune system is directing our body in certain ways to kill the virus. Reported side effects of COVID-19 vaccines have mostly been mild to moderate and have lasted no longer than a few days. Typical side effects include pain at the injection site, fever, fatigue, headache, muscle pain, chills and diarrhoea.

Diabetes medications does not affect the effectiveness of vaccine, and vice versa. Usual medication should be taken as prescribed unless individuals are experiencing severe symptoms mentioned. If these occur, immediate consultation with their health care provider is paramount. Some side effects might cause fluctuation of blood sugar. This is because our body produces stress hormones when we are ill, and these hormones raise blood sugar. Monitoring blood sugar is crucial and adjustment of medications especially insulin is important. People with diabetes are advised to seek medical help if they are experiencing hyper or hypoglycemia symptoms or if they are unable to eat or drink.

In the best-case scenario, people will be fully immunised after completion of vaccination. However, some may still get infected if they were exposed to the virus later. They may not aware as they are without symptoms or they may develop milder symptoms. Most importantly, all available COVID 19 vaccines will protect us from severe COVID 19 disease and death. The vaccines help us to prevent spreading of virus to our loves one (those who are not eligible for vaccination ie young children).

In a nutshell, it is a fact that people with diabetes are more likely to develop severe form of Covid 19 and they should be prioritised to be protected from the disease. Current Covid 19 vaccines are safe and effective. The best vaccine for you is the one that are made available for you.