Post-Covid fatigue is most prevalent in diabetes patients: Study

People with Type-2 diabetes who also suffered Covid-19 are more likely to experience severe fatigue than those who did not have the infectious disease, according to a new study released on Thursday. Post-Covid syndrome or Long Covid has emerged as a major roadblock in the recovery of patients infected with SARS-CoV-2. Amidst many symptoms such as myalgia (muscle pain), headache, cough and breathlessness, fatigue is most prevalent and makes a Covid patient severely debilitated.

The first-of-its-kind study, conducted jointly by Fortis C-DOC, AIIMS, C-NET, N-DOC and Diabetes Foundation, is published in the journal Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

The results show that diabetes complicates the course of Covid-19 and results in excess morbidity and mortality; presence of diabetes also influences Long Covid via various pathophysiological mechanisms. Besides, diabetes also poses challenges in the recovery of patients.

"Fatigue is a predominant and very debilitating factor, present afterwards in both hospitalised and non-hospitalised Covid patients. Fatigue and associated symptoms decrease quality of life and interfere with normal working capacity," Dr Anoop Misra, Executive Chairman and Director, Diabetes and Endocrinology, Fortis C-DOC, shared in a statement.

"In addition, diabetes poses challenges in the recovery of patients. It is imperative, therefore, for chronic diabetic patients to follow a healthy lifestyle, adhere to treatment guidelines and go for regular health checks," added Misra, who is also a Padma Shri recipient.

The team assessed the prevalence of fatigue among 108 Type-2 diabetes patients using the Chalder Fatigue Scale (CFQ-11) and handgrip strength (as a surrogate marker for sarcopenia or muscle mass and power) after Covid-19 infection. They compared them against patients with diabetes without a history of Covid-19 (52 Type 2 diabetes patients with Covid vs 56 Type 2 diabetes patients without Covid).

While Type-2 diabetes patients who had Covid-19 showed significantly more fatigue compared to those who did not have Covid-19, both groups had comparable handgrip strength.

Among diabetes patients, those with increased fatigue level had significantly higher inflammation markers during acute illness, and post Covid-19, had increased postprandial blood glucose levels.

They also lost more weight, had reduced physical activity and showed significantly lower handgrip strength as compared to those with lesser fatigue score. Overall, high fatigue seems to result from severe Covid-19, and high blood sugar levels, the researchers said.

The findings are particularly relevant in view of increased prevalence of severe diabetes during times of Covid-19.

"This study re-emphasises that the management of diabetes should be sustained and more stringent during a pandemic. Blood glucose and blood pressure should be optimal and more aggressive glycemic management is required," Misra said, adding that patients must focus on nutrition and protein and vitamin supplements.

Further, exercise and physiotherapy should be started early after Covid-19 as it may benefit not only fatigue but cardiovascular and pulmonary health and mental well-being of the patient, Misra suggested.