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Covid-19 and Diabetes

The world is in the grip of the covid-19 pandemic1

At the end of 2019, a novel coronavirus (a specific virus that causes human and animal disease) was identified as the cause of pneumonia cases in Wuhan, a city in the Hubei Province of China. It rapidly spread thereafter, resulting in an epidemic throughout China, with quick spread globally, affecting now nearly every continent. Understanding of this novel coronavirus is still evolving.2

As someone who’s living with diabetes, you must have a lot of questions regarding this new pandemic and diabetes. Below, we answer some of the most frequently asked questions based on current knowledge of COVID-193

Q: Are people with diabetes more likely to get COVID-19?

A: People with diabetes are not more likely to get COVID-19 than the general population. The problem people with diabetes face is primarily a problem of worse outcomes, not greater chance of contracting the virus.

Q: Do people with diabetes have a higher chance of experiencing serious complications from COVID-19?

A: People with diabetes do face a higher chance of experiencing serious complications from COVID-19. In general, people with diabetes are more likely to experience severe symptoms and complications when infected with a virus.

Your risk of getting very sick from COVID-19 is likely to be lower if your diabetes is well-managed. When people with diabetes do not manage their diabetes well and experience fluctuating blood sugars, they are generally at risk for a number of diabetes-related complications. Having heart disease or other complications in addition to diabetes could worsen the chance of getting seriously ill from COVID-19, like other viral infections, because your body’s ability to fight off an infection is compromised.

Viral infections can also increase inflammation, or internal swelling, in people with diabetes. This is also caused by above-target blood sugars, and both could contribute to more severe complications.

Q: Do I need to worry about DKA (diabetic ketoacidosis)?

A: When sick with a viral infection, people with diabetes do face an increased risk of DKA (diabetic ketoacidosis), commonly experienced by people with type 1 diabetes.

DKA can make it challenging to manage your fluid intake and electrolyte levels—which is important in managing sepsis. Sepsis and septic shock are some of the more serious complications that some people with COVID-19 have experienced.

If your blood sugar has registered high (greater than 240 mg/dl) more than 2 times in a row, check for ketones to avoid DKA.

Q: Is COVID-19 different from the seasonal flu?

A: COVID-19 is proving to be a more serious illness than seasonal flu in everyone, including people with diabetes. All of the standard precautions to avoid infection that have been widely reported are even more important when dealing with this virus.

Recommended safety precautions are the same as for flu, such as frequent hand washing and covering coughs and sneezes with a tissue or your elbow.

Q: What are the symptoms and warning signs I should be watching out for—and what do I do if I think I’m developing them?

A: Pay attention for potential COVID-19 symptoms including fever, dry cough and shortness of breath. If you feel like you are developing symptoms, call your doctor.

When you call:

  • Have your glucose reading available
  • Have your ketone reading available
  • Keep track of your fluid consumption (you can use a 1-liter water bottle) and report
  • Be clear on your symptoms (for example: are you nauseated? Just a stuffy nose?)
  • Ask your questions on how to manage your diabetes

Q: What are the emergency warning signs—and what should I do if I’m experiencing them?

A: If you develop emergency warning signs for COVID-19 get medical attention immediately. In adults, emergency warning signs include:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

Q: What should I do to prevent the spread of COVID-19 in my home—and what do I do if someone in my household has the virus?

A: For people with underlying health conditions, including diabetes, healthy family members in the household should conduct themselves as if they were a significant risk to them. For example, they should be sure to wash their hands before feeding or caring for them. If possible, a protected space should be made available for vulnerable household members, and all utensils and surfaces should be cleaned regularly.

If a member of your household is sick, be sure to give them their own room, if possible, and keep the door closed. Have only one family member care for them, and consider providing additional protections or more intensive care for household members over 65 years old or with underlying health conditions. Learn more about how to keep your home safe here.

References: 1. Grant W, Lahore H, McDonnell S, Baggerly C, French C, Aliano J et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020;12(4):988. 2. COVID-19 outbreak: guidance for people with diabetes [Internet]. Idf.org. 2020 [cited 20 June 2020]. Available from: https://idf.org/our-network/regions-members/europe/europe-news/196-information-on-corona-virus-disease-2019-covid-19-outbreak-and-guidance-for-people-with-diabetes.html. 3. How COVID-19 Impacts People with Diabetes | ADA [Internet]. Diabetes.org. 2020 [cited 20 June 2020]. Available from: https://www.diabetes.org/coronavirus-covid-19/how-coronavirus-impacts-people-with-diabetes

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