Global Health Asia-Pacific September 2020 September 2020 | Page 57

Recommendations for people who have diabetes and
obesity are as follows:
1. Make sure you have all the relevant contact details
at hand including those of your family and medical
practitioners in case you fall ill.
2. Be mindful of your blood sugar control. This is
especially true as any infection can cause a rise in
your blood sugar levels. Additionally, in this period
of the circuit breaker in Singapore, blood sugars
can be extremely erratic.
3. With regards to food, try to give priority to foods
with low glycemic index (for example vegetables,
brown rice and whole-wheat). Try to choose lean
proteins (for example meet, aches, beans, fish) and
8 green leafy vegetables. Try to have fruits daily to
2 or 3 servings.
4. Try to avoid snacking if possible. Therefore,
limit the consumption of foods high in sugar,
carbohydrates and fat.
5. Make sure you have a su�cient supply of your
diabetic medication. Think of what you may need
especially free of the quarantine yourself for a few
weeks.
6. Make sure you are able to correct the situation if
your blood sugars fall too low.
7. If you live alone, make sure someone you know or a
relative can provide assistance if you are unwell.
8. Try your best to keep a regular schedule despite
being mostly confined to your home. Avoid
overworking, get enough sleep and try to exercise
as much as possible.
Can I undergo Metabolic or Bariatric surgery to
treat my poorly controlled Diabetes?
Yes, Bariatric or Metabolic surgery is indicated
and if your BMI >32.5 with co-morbidites such as
Diabetes, hypertension, high cholesterol etc or BMI
>37.5 even without any co- morbidities. It is strongly
recommended if your diabetes is not under optimal
control despite medications as this can lead to
serious complications such as kidney damage, liver
damage, heart attacks, stroke and nowadays COVID19
infection.
If I choose to go for bariatric surgery during
the COVID19 outbreak , am I at HIGHER RISK of
catching Covid-19 ?
Generally speaking, No...however when our pandemic
status is in DORSCON orange most hospitals will
reserve surgeries usually for emergencies and semi
emergencies only. This is to be prepared if the health
care system is overwhelmed with COVID 19 cases.
We would recommend that since bariatric surgery
is an elective case it can be done when the cases in
Singapore take a downward turn and ideally with no
new cases for a week or two. You should check with
your bariatric surgeon when he or she can perform the
surgery at the earliest.
Will bariatric surgery reduce the risk of getting COVID?
If I choose to have bariatric surgery, will it
DECREASE my risk of getting COVID?
Yes, it will but not immediately. Obese individuals are
at a higher risk of contracting COVID because of the
decreased immune response in their body, diet low in
antioxidants and fiber as well as sedentary lifestyle.
Due to excess fat, there is decreased movement
of respiratory muscles such as the diaphragm and
therefore when they do contract the virus they also
have an increased risk of complications requiring ICU
stay and mortality.
Bariatric surgery will result in rapid weight loss.
The benefits of bariatric surgery to the person will be
evident after around 10-15% excess body weight loss
which will take about 3-6 months. COVID 19 is likely
here to stay in the long term and therefore it may be
prudent to get your surgery as soon as the hospitals
open for elective surgery so as to decrease your risk
of infections in the long term. Metabolic surgery for
diabetes control, however, can result in remission of
diabetes within a week after surgery and thus one
can decrease risk of COVID infection as soon as the
person recovers from surgery.
Dr. Ben Ng is a senior
endocrinologist at
Arden Endocrinology
clinic, Mount Elizabeth
Novena Hospital,
Singapore. He
specialises in Diabetes,
Obesity & thyroid
Disorders.
Dr. Jaideep Raj Rao is
the senior consultant
surgeon at JR surgery at
Mount Elizabeth Novena
Hospital, Singapore and
specializes in Minimal
Access Bariatric &
Gastrointestinal surgery.
GlobalHealthAsiaPacific.com
SEPTEMBER-OCTOBER 2020
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