Dr. Irl Hirsch discusses COVID-19: Part 3

Brook is committed to bringing you up-to-date and accurate info about COVID-19. Brook Health Director Heather King interviewed Dr. Irl Hirsch (virtually of course!) to answer some common questions and concerns. In the third part of this interview series, Dr. Hirsch discusses some precautions to take when doing physical activity at home. 

Irl Hirsch, MD, Endocrinologist and Professor at University of Washington, and Head of Brook’s Medical Advisory Board

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Hi Dr. Hirsch, thanks for having another virtual meeting with me. So, here we are, almost mid-April, and we’ve been under stay-at-home orders for a month now. How long can this last?

That really is the big question now, and unfortunately, there is no clear answer. We do know that a vaccine is being worked on, but vaccines are never 100% effective, and they can have side effects. Other than exposure or a vaccine, there’s no way So, it’s unclear to everyone how long this current scenario will continue.

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We know that some people are becoming ill with the virus and are having varying degrees of symptoms. Besides sickness from COVID-19, are you and your colleagues seeing any other ‘collateral damage’ with patients right now…what health issues are people dealing with?

Interestingly, now that the weather is getting nicer, people are becoming more active. Some are heading outside to be active, and some are starting an online activity program or workout app, many of which are being shared by friends and family right now. As a result, we are seeing a lot more physical injuries right now, such as knee, hip, and back injuries, especially in middle-aged to older people. We are even seeing this as a result of spring cleaning right now!

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That’s a very good point, and honestly, one that I hadn’t thought of – the fact that people are changing up their activity routines now, due to the weather, but also because they are stuck at home and can’t do their usual routines at the gym or at classes. What are some concerns about this that you’d like to share with us?

If people move too quickly into a new routine, or even with cleaning out their basement, they are more likely to become injured. Some of these injuries may require them to seek medical care at a clinic or hospital, which, of course, puts them at greater risk of exposure to the virus. As people are cooped up for longer, we are seeing more people presenting with these types of injuries, and that is worrisome.

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Besides starting slowly, any additional advice for people who are looking to add more activity during this time?

There are some good workout apps available, but few of these take into account age, weight, and co-morbidities of participants. Virtual trainers are available, however, and these can be a great option if you are an older individual, have not been previously active, and/or have risk factors – obesity, physical concerns, such as arthritis or pre-existing muscle or joint pain, etc. A trainer will be able to take these factors into account when designing an activity routine for you.

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Great advice. Any recommendations to share with people who might be trying to manage diabetes and increasing or changing their activity routine right now?

Absolutely. The most important issue here, in addition to avoiding injury, is to check blood sugar more frequently when increasing or changing activity. This is especially true if someone is on insulin or a sulfonylurea, both of which can cause low blood sugars. You might not think a new activity is more taxing than something you used to do, but you can’t know without checking your sugar before and after exercise, and even during, if lows are a concern for you.

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What about people who are taking multiple doses of insulin and are checking their blood sugar several times a day already? This would mean pricking their fingers even more often. Any advice for dealing with that?

If you are on insulin and check your blood sugar multiple times a day, talk to your provider and health insurer about your eligibility for a continuous glucose monitor (CGM). This may be covered by your insurance, and will make it easier for you to get frequent blood sugar readings without all the finger pricks.

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Good idea. People may be eligible for a CGM and may not even realize it.

Yes. And CGMs are very helpful for closely monitoring blood sugar, as well as being easy to use for most people.

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So, the big message I’m hearing is that people should stay active during this time, but should do so safely. That means taking it slow when switching or increasing activity, working with a virtual trainer if you have risk factors, and closely monitoring blood sugar if you have diabetes and are at risk for lows. The Brook Experts can definitely support our users in figuring out which of these factors are important to them, and in assisting them in finding a healthy activity routine.

That’s great. We should all be leaning on our support systems now.

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Thank you again for taking the time to meet today, and for sharing this very practical advice. 

You are most welcome. Stay safe!

Responses were edited for length and clarity.

We understand that there’s a lot of information and, unfortunately, misinformation going around right now. Google and Facebook can be a scary place. Brook’s medical board and team of health experts are working to sift through the information to bring you what’s pertinent, important, and true.

Reach out to our Health Coaches any day of the week for questions or support.

If you feel like you are experiencing symptoms of COVID-19, stay home, be sure to call your healthcare provider and follow protocols established by the CDC or World Health Organization.

Interview done by Heather King, MS, RDN​, CDE

on April 12th, 2020. Heather is a Certified Diabetes Educator, has been a Registered Dietitian for over 12 years and is Brook's Health Director.