Importantly, people with diabetes should know that they aren’t more likely to get COVID-19 than the general population, the American Diabetes Association (ADA) says in its online “COVID-19/Coronavirus” resource. Instead, those with diabetes face a higher chance of experiencing serious complications if they contract COVID-19. Data from the cases in China, for instance, show that people with diabetes had much higher rates of serious complications and death than those without diabetes. In general, those who have more health conditions, such as diabetes and heart disease, have a higher chance of experiencing serious complications, the ADA says. Plus, being ill can make it more difficult for those with diabetes to manage their glucose levels, especially if they feel unwell and can’t eat certain foods. “Make no bones about it—COVID-19 is serious and is a serious challenge to our society and to our personal and community health,” says Ken Moritsugu, ADA’s chief interim science and medical officer. Moritsugu and ADA CEO Tracey Browncreated a 5-minute video on coronavirus for the ADA website. “Our community continues to be of utmost importance,” Brown says. “As we get more information, we will share that with you.” People with diabetes shouldn’t worry or panic. Instead, they simply need to take extra precautions, monitor their glucose regularly, and practice social distancing and hand washing guidelines, as recommended by the Centers for Disease Control and Prevention.
What is the coronavirus?
SARS-CoV-2, the virus that causes the disease known as COVID-19, first began infecting humans in China at the end of 2019. It’s a new virus that previously infected animals, so humans don’t have a natural immunity yet to fight against the infection. Since the virus spreads through respiratory droplets (from coughing and sneezing) and human-to-human contact (such as handshaking), the CDC has recommended that everyone be cautious.
How might my diabetes interact with the coronavirus?
Researchers are learning new facts daily about SARS-CoV-2 and COVID-19. The latest studies, which are being published in medical journals such as the New England Journal of Medicine and The Lancet, are based on data from the cases in China and elsewhere. As new information becomes available, experts at the ADA and other diabetes organizations are posting updates on their websites. “There is a lot we still do not know about COVID-19. What we do know is based on the limited research available to us at this time. What we know at this time, of those who have become very sick with the virus, about one-fourth have had diabetes,” says Kellie Antinori-Lent, the 2020 President of the Association of Diabetes Care & Education Specialists. “We have always known that living with high blood glucose puts patients living with diabetes at risk for infections because it impairs the body’s immune response or, in other words, the body’s ability to fight off a virus,” she says. “This holds true with COVID-19.” That means people with diabetes should manage blood glucose levels as close to their goal as possible, she says. Those with diabetes who have other serious underlying medical conditions, such as heart disease or lung disease, are at higher risk for severe illness if they become sick with COVID-19, she adds.
What if I havetype 1 diabetes?
At this time, researchers aren’t sure if there is a difference in infection rates between prediabetes, type 1 diabetes and type 2 diabetes, says Dr. Anne Peters, a leading diabetes clinician with the Keck School of Medicine at the University of Southern California. Peters created a video for Medscape to help doctors understand more about the interactions between coronavirus and diabetes and how to help their patients. Studies also can’t currently say whether those with certain A1c (average blood sugar over the past two to three months) levels fare better than others. With type 1 diabetes in particular, blood or urine ketones should also be checked. Moderate or high levels require medical attention, Antinori-Lent says.
How should I monitor my glucose during the outbreak?
People with diabetes should continue to monitor their blood glucose levels as prescribed by their healthcare provider at this time, Antinori-Lent says. However, if you become ill or do not feel well, it is advised to monitor your blood glucose levels more often, such as every three to four hours. If you wear a continuous glucose monitor, it is advised to look for elevations in readings. When levels stay > 240 mg/dL despite taking additional correction insulin, you should call your doctor, she says. “Everyone with diabetes needs to prepare,” Peters says. “Be sure to have medications available with as many refills as possible.” Check with your doctor to ensure you can receive as many refills as you can. If you don’t use them already, look into delivery or mail order options so you don’t have to travel to a pharmacy in person, if needed. In addition, have a glucose meter and test trips at home, in case you need them, Peters adds. Check that you have enough supplies to manage your diabetes, including syringes, pens, insulin pump supplies, alcohol swabs, glucagon and anything else you need.
What are the coronavirus symptoms?
The recorded cases of COVID-19 have included a range of mild to severe symptoms, according to the CDC. About two to 14 days after exposure, people may experience:
FeverCough, especially a dry coughShortness of breath
The CDC recommends contacting your doctor and seeking medical attention if you exhibit “emergency warning signs” of COVID-19, including:
Difficulty breathingPersistent pain or pressure in the chestBluish lips or face
Those with diabetes should contact their doctors first before going to a hospital, the ADA suggests. Be ready to talk about your glucose and ketone readings, your symptoms and your fluid consumption. Your doctor will advise what to do next.
What should I do to prepare?
Practice the CDC’s social distancing recommendations of staying six feet away from other people and not being in crowds of more than 10 people at a time. Be cautious in areas with large numbers of people, such as grocery stores or gatherings. If you don’t already have one, develop a sick day management plan with your healthcare provider. “Write it down and store it in a place easy to find,” Antinori-Lent says. “Things always go smoother when you are prepared.” Create a stock of both sugary and non-sugary fluids at home, including electrolytes and broths, so you can consume fluids, whether you need carbohydrates or not, Peters says. Buy nonperishable foods for your pantry as well, in case of emergency. “Patients with diabetes need to remember to look after themselves, knowing that changes in lifestyle, stress and illness can impact glucose levels in all sorts of ways,” Peters says. “Be mindful of your levels and adjust as needed to stay in the normal range.” Find additional information and updates here:
American Diabetes Association COVID-19/Coronavirus pageCenters for Disease Control and Prevention COVID-19/Coronavirus pageorg (for those who are struggling to pay for resources)Medicare & Coronavirus update pageCall 1-800-DIABETES (800-342-2383) if you need more information and help.
Next, here’s how to help out healthcare workersduring the coronavirus pandemic.
Sources
Ken Moritsugu, ADA’s chief interim science and medical officerKellie Antinori-Lent, the 2020 President of the Association of Diabetes Care & Education Specialists
