Those
who need to be extra care - during dengue season
We have many untoward accidents due to dengue every
monsoon in this region. Therefore, experts are asking people who are in a
vulnerable condition for various reasons - such as diabetic patients and
pregnant women - to be careful.
Dr. said - There is a warning for diabetic patients
during dengue season, Diabetic patients' blood density increases due to excess
glucose, which increases the risk of dehydration. Diabetic patients also have
low immunity. Those whose diabetes is not well controlled (blood glucose is
higher than the desired level) are more likely to suffer from dengue fever.
Various studies have already proven that if the
three-month average of blood glucose or HbA-1c is high, the risk of dengue
complications is higher.
The main cause of death in dengue is dengue shock
syndrome (DSS). If diabetic patients are infected with dengue fever, the risk
of dengue shock syndrome increases significantly. Their mortality rate is also
very high.
Warning
message from the doctor ---
a. Be
careful if someone in your home or surroundings has dengue. Sleep under a
mosquito net during the day, use mosquito repellent cream. If you have dengue,
drink enough water and fluids, but choose sugar-free fluids because you have
diabetes. For example, sugar-free fruit juice, saline solution, coconut water,
soup, etc.
b. Try
to keep your diabetes under control. This reduces the risk of complications.
Keeping your fasting blood sugar below 6m.mol/L, below 8m.mol/L two hours after
eating, and keeping your HbA1c below 7 is called well-controlled diabetes.
c. If
you have uncontrolled diabetes or its complications (such as kidney disease,
protein in the urine, heart disease), it is better to be hospitalized and
treated if you are infected with dengue fever.
d. Even
if you have dengue, you cannot stop taking your usual medications for diabetes,
such as insulin or oral medications, etc. However, SGLT inhibitors can increase
the risk of dehydration. Dengue can cause loss of appetite, vomiting, and the
patient cannot eat anything. Therefore, blood sugar levels may drop. The dose
of insulin or oral medications may need to be changed. In that case, you need
to consult a specialist.
e. Most
diabetic patients take high blood pressure medications, aspirin, etc. It is
better to stop aspirin during dengue. A decision about blood pressure medications
should be made depending on the tendency of blood pressure to decrease.
f. If
you have kidney or heart complications with diabetes, you need to be very
careful about giving saline.
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Caution for pregnant women in dengue ---
Experts say that pregnant women are at high risk
during dengue outbreaks due to their weaker physical condition and immune
system than normal.
They are also more likely to have complications.
However, no data has been found yet on miscarriage or physical complications in
children if they contract dengue in the first three months of pregnancy.
Dengue in the last three months does not pose the same
risk of premature birth. If a woman contracts dengue in the last three months
of pregnancy, there is a risk of transmission of the virus from mother to
child.
Among the complications of the mother, sudden bleeding
is the most worrisome symptom. Excessive bleeding may occur during or after
childbirth or surgical delivery (cesarean section). There may be fluid
accumulation in the chest, liver problems, bleeding in the gums or any other
part of the body.
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Doctors say about precautions in case of dengue --
If a pregnant woman is infected with dengue, she must
be admitted to the hospital. At this time, the symptoms of dengue are similar
to other complications (such as HELLP syndrome or increased liver enzymes and
decreased platelets in the blood). Therefore, treatment under the supervision
of an experienced medical specialist is essential.
Keep an eye on whether the patient's heart rate, blood
pressure, pulse, and pressure are being monitored in the hospital every four
hours. It is important to urinate 100 cc every 4 hours. Hemoglobin, hematocrit,
and platelet counts should be checked daily. If fluid accumulates in the chest,
breathing difficulties may occur. Every aspect should be monitored closely.
As per the doctor's advice, you can take paracetamol
during fever. If someone has already taken aspirin, it is better to stop at
this time. You should drink more water and fluids. However, if vomiting is
severe, saline can be given intravenously.
After the fever subsides, the critical phase begins.
If there are signs of plasma leakage at this time, saline should be given with
caution.
During the critical phase, childbirth or delivery
through surgery should be avoided. If labor pains begin, delivery should be
done under the supervision of a specialist medical team.
If necessary, single donor platelet transfusion may be
required. If the patient progresses from the critical phase to dengue shock
syndrome, the patient should be kept in the intensive care unit (ICU).
Any injection into the muscle should be avoided during
dengue. It should be determined whether the newborn is infected from the mother
or not. If the newborn is infected, treatment should be provided under the
supervision of an experienced pediatrician.
During a dengue outbreak, pregnant women should try to
stay under a mosquito net at home like a diabetic patient or wear mosquito
repellent to protect themselves from infection. Be especially careful if
someone in the house or around them has dengue. Seek medical attention if you
have a fever. This is not a matter of negligence at all. You should give the
importance of precaution - to lead a healthy life.
