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Sugar and COVID-19

The COVID-19 pandemic is super new to science, it often takes years before scientists can prove the connection between risk factors and conduct supporting studies, but now is not the time to wait. I am in quarantine and observe various facts about COVID-19, based on them, the “Hypothesis on the relationship between blood sugar and infection” looms. The only reason I post on such a controversial topic is because I truly believe that this information can save lives. The lives of my friends, their friends and their relatives.

DisclaimerThis is not an article about drugs or treatment methods, but about how rationally, based on the observed worldwide relationships between high blood sugar and the severity of the disease, to comply with recommendations for activity and added sugar. The British Health System, NHS, is my reference here, and it recommends added sugar of 30 g. adults, 24 gr. from 7 to 10 years and 19 gr. from 4 to 6 [0].

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The pandemic COVID-19, a potentially severe acute respiratory infection caused by the SARS-CoV-2 coronavirus (2019-nCoV), has officially been announced in the world. There is a lot of information on Habré on this topic - always remember that it can be both reliable / useful, and vice versa.

We urge you to be critical of any published information.


Official sources

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At the moment, we have heard a lot about people with chronic diseases who have a higher mortality rate after COVID-19, and especially people with diabetes. According to the WHO definition, diabetes is a chronic metabolic disease characterized by high levels of glucose in the blood (or blood sugar) [12]. A large amount of blood flow proteins is glycated in the body, which means "pieces of sugar are attached to the surface of a huge protein molecule in different places." One of the most common proteins in the blood is hemoglobin (Hb), and the degree of glycation of Hb (i.e. the amount of sugar on its surface) is often measured to confirm diabetes, which is very logical. Because people with diabetes have higher blood sugar, their hemoglobin is more “sugar coated” than healthy people. Interestingly, for diabetics,which correctly control blood sugar, there is a decrease in the degree of glycation of hemoglobin. Remember this fact.
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We must also know that hemoglobin is a protein for the transfer of oxygen from small sacs (alveoli) in the lungs to all cells of the body. For this, hemoglobin includes an iron atom (and iron already binds oxygen). Hemoglobin is found in red (due to iron) blood cells (erythrocytes) and these cells are renewed every 4 months along with hemoglobin, therefore glycated hemoglobin reflects our “average blood sugar” for the last 3-4 months. Since there is a lot of it in the blood and it is easy to excrete it, it becomes a convenient marker and is not directly related to the complications of diabetes.


Any infection, whether bacterial or viral, in fact, is a very fast multiplication of the infectious agent. Bacterial cells do this by dividing the cells, that is, every cycle, they double. Viruses are pieces of information covered with proteins, they penetrate cells and “embed” their program into the cellular mechanism of our own cells, that is, our own cells produce more and more copies of the virus. At some point, the cell dies and all copies enter the body to infect even more other cells. This can happen much faster than bacterial division, since the virus is much smaller and gathers faster.

Production speed depends on the availability of resources to create more viruses. For millions of years, viruses have evolved, they have learned to steal glucose from our own cells for their construction, accelerating the metabolism of infected cells, and our infected cells accelerate the consumption of sugar from the blood. If there is more sugar in the blood, production will be faster.

To fight the virus, other cells in our body also accelerate and use sugar to prepare an immune response. Part of this immune response is the production of cytokines. It is well known that if the immune response is too fast, it can damage tissues, trying to save the body. This is called the Cytokine Storm. It can cause bleeding in tissues where there is an infection. Doctors even slow down the cytokines with drugs (inhibit) to save our body from our own immune response.

Recently, scientists [1] studied common flu and showed that patients infected with the infection have higher blood sugar levels than normal. That is, sugar is a risk factor for infection.

This is already interesting. I watched several friends on my social networks who had very mild symptoms, and after recovering from COVID they had enough antibodies to donate blood to those who are very sick. I know some of them are on a sugar-limited diet. In reasoning, more and more meaning appears.

A group of doctors in the United States also found this association [2]. Their study found that people with diabetes and poorly managed hyperglycemia (high sugar) who were hospitalized for COVID-19 had a mortality rate four times higher. Forty-two percent of those who did not have a preliminary diagnosis of diabetes before admission to the hospital, but who developed hyperglycemia while in the hospital, died. Experts say it’s now important to limit the number of hospital visits for people with diabetes in order to protect themselves and health workers, as well as reduce the burden on the health system.

Adam M. Brufsky, a professor of medicine in Pittsburgh, talks about another interesting fact about COVID and sugar [3]. He mentions that the COVID virus uses specific proteins on the surface of our lungs. The protein is called ACE. This protein is very common on the surface of lung and pancreas cells. He describes that if this ACE protein is sugar coated, it is easier for the virus to attach to it. And since the virus infects the pancreas (due to the ACE protein on the surface), even more sugar appears in the blood (the same hyperglycemia). Why is that? An infected pancreas produces less insulin, and sugar from the bloodstream is not absorbed into the cells. This additional sugar, it glycates even more ACE proteins in the lungs and pancreas. This is a real chain reaction, at the origin of which was sugar.

Professor Brufsky’s hypothesis is based on the observation of SARS (an epidemic in 2003 caused by a virus similar to the COVID-19 virus), where the above pancreatic damage mechanism is well known. Now, for patients with COVID, doctors are also observing hyperglycemia. A drug called "hydroxychloroquine" is now being used more and more, since it stops glycation and sugar does not attach to proteins, that is, it stops the chain reaction.

Why sugar coating, glycation, is so important for the virus. I imagine it as Jam, the more sugar on the surface of viral proteins and ACE, the easier it is for them to stick to each other. Like jam that stuck to the table.

Hemoglobin, lung damage, and sugar.

Yesterday I spoke with my friend Vardan, a brilliant heart surgeon, and it was this conversation that made me think about sugar and collect all this information. Vardan is one of those doctors who fell ill at work; for the past 20 days he has been a patient. When he saw a CT scan, he decided to record a video for his family, it was all bad. His exact words were: "This is not pneumonia, we say that it is a broken hemoglobin, but you better know."

Indeed, the last grant I prepared at the European Research Institute for Aging (ERIBA) was on protein oxidation, glycation and aging. We believe that aging is affected by high blood sugar, at the molecular level inside and outside the cells, sugar residues affect our perfect life machines. Like hemoglobin and ACE, each protein in the cell is slowly coated with sugars. Imagine the gears inside the watch, covered with mud, at some point the watch will stop.

Returning to hemoglobin, the main problem with COVID is a decrease in functional space in the lungs. The lungs can be thought of as an inverted tree, where the trachea is the trunk, and the lungs are branches that branch and become smaller and smaller. The smallest branches contain small air sacs - alveoli, they are only 0.2 mm in size and with very thin walls of 0.02 mm, which serve as a partition between them. In the lungs, 600 million alveoli. It is in the walls of the alveoli, where the thinnest blood capillaries pass, that oxygen is exchanged. Hemoglobin takes oxygen from the air and delivers it throughout the body. It is the cells of the alveoli that are infected by the virus during COVID-19.



Imagine now a high blood sugar level causes a cytokine storm, and the immune system attacks the thin walls of the alveoli, as a result, the blood spills out. When blood comes in contact with air, it begins to coagulate - proteins (mainly fibrinogen) adhere to each other. This is a normal process, and it protects us from bleeding, when we cut ourselves, a clotted piece of blood is called a blood clot.

Diabetics have a higher risk of thrombosis, diseases when blood clots and blood clots appear in the blood vessels. We actually know a lot about clots inside large vessels or about when a vessel is damaged. It is also very likely that hemoglobin is present in the alveoli as an additional coagulation enhancer when it leaves damaged blood cells. Some studies on this subject have been summarized recently [4]. This seems to be the case with the complications in COVID.

The more virus there is in the lungs, the more likely it is to get internal bleeding and blood clots. Blood coagulates, and less and less space is left for oxygen exchange, and the patient will eventually die from low oxygen levels in the blood. If the proteins are coated with sugar, they stick even better, the analogy with Jam. There is much evidence of increased thrombosis in patients with diabetes [6]. All because of sugar.



Another recent hypothesis [7] is that the COVID virus also attacks hemoglobin itself, or rather, a part of it called porphyrin. Porphyrin is a ring inside hemoglobin that holds iron. Interesting yes? The virus destroys our oxygen transport proteins, and broken proteins stick even more to clots in the lungs, hence the frosted glass on CT. Our blood with impaired hemoglobins transports less oxygen, and blood clots reduce the available space for oxygen exchange in the lungs. I bet that when hemoglobin is coated with sugar, it’s much easier for the virus to stick to it and destroy the protein. The viral proteins themselves are also coated with sugars, so the analogy with Jam is here again.
The last statement is widely discussed on the Internet as working with incorrect methods, it is better to leave it as a hypothesis, but the data is already enough to be sure - high blood sugar is a predictor of complications with COVID.

Everything falls into place

If you have low blood sugar: the virus has less building material for reproduction, it is more difficult to cause a cytokine storm and bleeding, damage to the pancreas will not lead to even higher blood sugar. Even if bleeding begins, blood clots are less sticky. In addition, it is likely that the virus is more difficult to destroy hemoglobin containing oxygen. It is likely that you are breathing and you have enough time for the immune system to win.

If you have high blood sugar: the virus has many building blocks for reproduction, the cytokine storm is easily caused and bleeding begins, damage to the pancreas is even greater. Insulin is not produced and even more blood sugar and more sticky proteins. When bleeding begins, the clots become larger and stickier. In addition, there is a high probability that the virus easily destroys hemoglobin that carries oxygen. It is known that in such patients the rate of development of a chain reaction is several hours, they go from a normal state to a critical one and need oxygen supply.

Questions You Should Think About

What kind of food is given to people in the hospital? Does her blood sugar increase? After working inside and with hospitals in Russia, the UK and the Netherlands - I know what kind of food it is. And I know that bone broth would be its best substitute.

Recovery

Survivors are known to have fibrosis. These are the same clots in the lungs that become connective tissue, which makes people disabled for the rest of their lives. Clots can actually dissolve over time, in a process called lysis, but as we know, in patients with diabetes (or high sugar) [8], the lysis process is much worse because of the same jam.

Education

Funny, we conduct seminars for children using the contents of the book "The Adventures of Tim in the World of Bacteria" [9].



One of the questions during the seminar: “Imagine two children, one eating sweets, the other eating vegetables, both have wet feet. Who will be the first to get sick? ” Children answer easily, that is, quickly and correctly. C COVID is the same principle. Perhaps we just remove the substrate to spread the infection and control our own health.
If we turn to statistics, then in the Russian Federation Sugar consumption is 39.6 kg per year, which is a little more than 100 grams per day, which if compared with our standards will be 2 times higher than the norm, and if compared with the norms in the UK, then more than 3 times. A recent epidemiological study [11] in Russia conducted on 26,000 people, using the same glycated hemoglobin for diabetes and prediabetes, showed that 5.4% of diabetic patients (more than half were not previously diagnosed), and 19.3% are in a prediabetic state.

Links
0 - www.nhs.uk/live-well/eat-well/how-does-sugar-in-our-diet-affect-our-health
1 - www.scientificamerican.com/article/how-blood-sugar- can-trigger-a-deadly-immune-response-in-the-flu-and-possibly-covid-191
2 -https: //www.healthline.com/health-news/covid-19-impact-on-diabetes-hospitalizations
3 - theconversation.com/blood-sugar-levels-may-influence-vulnerability-to-coronavirus-and -controlling-them-through-conventional-means-might-be-protective-136592
4 - www.ncbi.nlm.nih.gov/pmc/articles/PMC5404239/pdf/nihms828160.pdf
5 - rebelem.com/covid-19 -thrombosis-and-hemoglobin
6 - www.heart.org/en/health-topics/venous-thromboembolism/understand-your-risk-for-excessive-blood-clotting
7 - chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoproteinote_mein_mein_me_binem_binem_binem_binem_binem_in_in_
8 - www.ncbi.nlm.nih.gov/pmc/articles/PMC2854507
9 -www.amazon.com/Adventures-World-Bacteria-Dmitry-Alexeev-ebook/dp/B08776J9B3/ref=sr_1_1?dchild=1&keywords=tim%27s+adventures+alexeev&qid=1588320782&sr=8-1
10 - www.factograph.info /a/29850257.html
11 - www.sciencedirect.com/science/article/pii/S0168822716300237
12 - www.who.int/health-topics/diabetes#tab=tab_1

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