High sugar after Covid a concern, but hypertension no bar for jab

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High sugar after Covid a concern, but hypertension no bar for jab

My son aged 45 is type-2 diabetic (not on insulin). He had Covid-19 and was discharged from hospital on May 17 after five days of treatment with remdesivir and steroids. His fasting sugar level is around 200 with medication. Our family doctor says this will continue for some more days. Is this okay?

—K JAYARAMAN, CHENNAI

Anyone who is ill tends to have high sugar. It lasts for a few days after the illness as well. Studies have shown Covid-19 also plays a role in keeping sugar levels high days after illness. Having said that, fasting sugar of 200mg/dL is not something we would be happy with given the concerns about other infections, such as black fungus. Therefore, it is important for the sugar levels to be brought down to a more acceptable value. It is worth talking to your doctor to see if more medicine should be added, or diet tightened.

I am 74, have hypertension but not diabetes or other comorbidity. I have never had Covid. Please let me know what precautions I should take before getting vaccinated to avoid complications like blood-clotting.

—PRASHANT K GUPTA, MEERUT

I would advise you to get vaccinated as quickly as possible. Data released by the government shows significant side-effects of vaccination are exceedingly rare. Studies have also shown the risk of blood-clotting is rare among the elderly. So, taking the vaccine is probably safer than taking a flight. Until now, no government or other agency has recommended routine tests ahead of vaccination. It may not be the best time to take the vaccine with symptoms such as high fever, but no other situation warrants postponement. You must continue with your regular medications.

Can DPP4 inhibitors given for controlling blood sugar levels in Covid cases help prevent black fungus?

—PRANAV DESHMUKH, MUMBAI

Control of blood sugar is important for everyone, but how it should be controlled is a conversation you must have with your doctor. If patients have fluctuating sugar levels, insulin is the most preferred mode of treatment. For others who are stable and do not have other health complications, many other drugs are available. What drug you must take depends on your medical conditions, such as kidney disease or liver injury.

Dr Rajeev Gupta

HEAD, INTERNAL MEDICINE, HOLY FAMILY HOSPITAL, DELHI

My mother has high cholesterol and BP. Should we stop her medication for a couple of days before and after vaccination? Should people with cholesterol and BP issues take aspirin around the time they get vaccinated?

—VENKATARAMAN, CHENNAI

Medicines for cholesterol, usually statins, should be continued.

Blood pressure needs to be under control before vaccination, so there’s no need to discontinue any prescribed medication. Aspirin is not added for the purpose of vaccination. If it is going on, it should not be stopped.

Does steam inhalation prevent Covid? Should it be done daily?

—SUNIL K GUPTA, RANCHI

Steam inhalation has no role in preventing Covid-19. All measures to improve your immunity, like regular exercise, healthy diet, vitamin supplements, yoga, etc have no immediate effect but they are all good in the long term.

My RT-PCR test is positive with a CT value of 31.6. Do I need home isolation? I have no fever, cough or cold.

—GOPAL SHAH, MUMBAI

The CT value (or cycle threshold) of RT-PCR is subject to many potential errors, and its value as a measure of viral load or severity is very questionable. Home isolation is decided on severity of symptoms, age and serious comorbidities. Asymptomatic patients without other risk factors, as judged by their treating physician, can be home-isolated. It is based on doctor’s advice, not CT value.

Is vaccination safe for my wife who is NMO+ve and suffering from myasthenia gravis? She is on immunosuppressants and was administered her 8th dose of rituximab in March 2021.

—AAKASH JAIN, JAIPUR

People who are immunocompromised or on immunosuppression can get vaccinated. What is not known is how good the immune response will be, as most studies didn’t include immunocompromised people. However, they should delay vaccination for 4-6 weeks after the last dose of any immunosuppressive agent. Your wife should undergo CBC (complete blood count) KFT and LFT tests before vaccination.

I am fully vaccinated but I don’t have a certificate of vaccination – it was not generated. Will it be required for travelling?

—DIPEN SAPOVADIA, AHMEDABAD

As of now, there is no regulatory mandate for producing a vaccination certificate for travel within India. Some countries might require a vaccination certificate though. In such instances, carrying certification is advised. I would recommend contacting the health centre where the vaccination was done to get the vaccination certificate.

Dr Subramanian Swaminathan

DIRECTOR – INFECTIOUS DISEASES, GLENEAGLES GLOBAL HEALTH CITY, CHENNAI

Dr Giridhara R Babu

PROFESSOR AND HEAD-LIFECOURSE EPIDEMIOLOGY, PUBLIC HEALTH FOUNDATION OF INDIA (PHFI)

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