India has been witnessing a massive spike in COVID-19 cases in the last few weeks, with deaths also reaching new records and The New York Times reports that there are now over 350,000 daily COVID-19 cases. Hundreds of thousands of deaths are likely to follow. With hospitals and caregivers struggling to help, one more sad twist is added to this calamitous situation; a black mold called Mucormycosis poses a threat for COVID-19 patients, particularly those who have diabetes, by putting their life and vision at risk.

The COVID surge and diabetes

India has been in the headline of newspapers worldwide given the massive surge of cases of COVID-19. As per BBC, at the start of the pandemic, India had done a remarkable job at keeping infections and transmissions low but cases have now risen exponentially and the country is in chaos and looking for international assistance and COVID vaccines.

As we reported before, diabetic populations are at a higher risk from COVID-19. Here you can read our articles on why COVID reinfections are a concern for people with diabetes and the long-term health issues from COVID.

Diabetes has a debilitating effect on people’s immune system, which causes people living with diabetes to take longer to fight infections and fully recover. It is also possible that the virus will live longer in a high glucose environment. When people with diabetes get a viral infection, it can be more difficult to treat it due to an increase in blood sugar levels.

It can also complicate matters if the individual has known diabetes complications e.g. heart disease, renal impairment, hypertension or other. In light of this, people with diabetes are considered at increased risk of severe illness from COVID-19 infections.

Here you can read more about how to deal with your diabetes during COVID-19.

The new fungus threat to diabetic patients

The cases of the new fungus, also called the “black fungus”, are growing in number. According to the New York Times, there are over 200 registered cases and more than five thousand doses of a specific anti-fungal called “amphotericin B” have been administered so far in the state of Maharashtra alone.

As stated in the Ars Technica article “The startling increase in cases may be explained by India’s high number of people with diabetes, coupled with poor hygiene amid the critical COVID-19 surge, doctors speculate. Mucormycosis is known to strike people who have compromised immune systems, especially people with diabetes—and those with poorly controlled diabetes in particular.”

People with diabetes have a weakened immune system that can give room to fungi and other pathogens to grow when compared to the non diabetic population. Mucormycosis is found in soil and air since it is a type of mold. The article before goes deeper, stating that “These molds love iron-rich, acidic environments, and diabetic ketoacidosis—a complication of diabetes that causes the blood to become acidic— is a key risk factor for developing mucormycosis”

Most of the recorded cases have been on people with advanced diabetes and that have had trouble keeping it in check. This is why proper diabetes management is so crucial for the entire diabetic population.

“Black fungus” leads to vision loss

The fungus seems to mainly attack the patients through the nose and sinuses. From there it can spread to facial bones, the eyes, and even the brain. In some cases, the fungus appears to attack the lungs, the gastrointestinal system or spread throughout the body in the blood stream.

When the fungus attacks the eyes, patients may experience various symptoms. They may develop blurred vision, drooping eyelids and swelling. In some cases, paients may need to have their eyes surgically removed to prevent the infection from spreading further.

According to Dr. Renuka Bradoo, head of the ear, nose and throat department of Sion Hospital in Mumbai, eleven of 24 reported cases had to lose an eye, and six of them died. Most of them are are middle-aged diabetic patients who were struck down by the fungus two weeks after recovering from COVID-19.

Sadly, most patients arrive late, when they are already losing vision. This means that doctors have to surgically remove the eye to stop the infection from reaching the brain. In some cases, patients have even lost vision in both of their eyes.

Diabetic Retinopathy is also a risk

Mucormycosis due to mold might be a fringe infection. Diabetic retinopathy is sadly not. Diabetes is in fact one of the leading causes of preventable blindness worldwide. Research has shown that vision loss due to diabetes can be prevented in over 90% of cases with early detection and timely treatment.

RetinaRisk’s solutions aim to empower diabetic patients to better understand their risk of vision loss due to diabetes and to motivate them towards enhanced diabetes control. We want to raise awareness about the risk of vision loss and the importance of good diabetes control.

We offer free calculations in the RetinaRisk app for a limited time. You can read more about it here . With the RetinaRisk app, you get an insight into your individualized risk of sight-threatening diabetic retinopathy during the next 12 months. All you need to do is insert the following six risk factors: gender, type and duration of diabetes, diagnosis of retinopathy, blood sugar (HbA1c) and blood pressure. If you don’t have this information at hand, be sure to discuss this with your healthcare providers.

Both doctors and patients can greatly benefit from the risk calculation. It allows patients to become more active participants in their own wellness journey. It enables doctors to obtain a fuller picture of the state of the patient.

We recommend everyone to read our entry on how to prevent diabetic retinopathy. It provides good insight into how to stay healthy and prevent the onset of this common complication of diabetes.