People of any age who have serious health issues such as diabetes might be at higher risk for severe illness from COVID-19, the new coronavirus disease that is now a global pandemic. There is plenty you can do to protect yourself, however.
Gather supplies and information, including:
Phone numbers of your doctors and health care team, pharmacy, and insurance provider
A list of all medicines you take (including vitamins and supplements) and their doses
Simple, easy-to-digest carbohydrates such as regular soda, honey, jam, or hard candy to help keep your blood glucose up if you are at risk for lows and too ill to eat
Extra refills of your medicines so you do not have to leave the house
Extra supplies such as rubbing alcohol and soap to wash your hands
Glucagon and ketone strips, in case of blood glucose lows and highs
Enough groceries to be able to stay at home for long periods of time
Take everyday precautions.
Avoid close contact with people who are sick.
Wash your hands often with soap and water for at least 20 seconds, especially after spending time in public places.
Avoid touching high-touch surfaces in public, such as elevator buttons, door handles, and handrails.
Avoid touching your face, nose, and eyes.
Clean and disinfect your home to remove germs, especially frequently touched surfaces such as doorknobs, light switches, faucets, handles, and cell phones.
Avoid crowds. If you must be around people you don’t live with, wear a mask over your mouth and nose, stay at least 6 feet away from others, and don’t shake hands.
If you get sick, call your doctor. Here are some common self-care tips:
Drink lots of fluids. If you’re having trouble keeping water down, have small sips every 15 minutes or so throughout the day.
If you have low blood glucose (below 70 mg/dL or your target range), eat 15 grams of simple carbohydrates and recheck in 15 minutes to make sure your glucose level is rising. Check extra times throughout the day and night.
Be on the lookout for continued high blood glucose levels that could lead to diabetic ketoacidosis (DKA). Take quick action if DKA develops. (See details on the next page.)
Be aware that some continuous glucose monitoring sensors (Dexcom G5, Medtronic Enlite, and Guardian) are affected by acetaminophen (Tylenol). Check your blood glucose with a meter to ensure accuracy.
Wash your hands and clean your injection/infusion and fingerstick sites with soap and water or rubbing alcohol.
Q. Are people with diabetes more likely to get COVID-19?
A. We don’t yet know whether people with diabetes are more likely than others to get COVID-19. But if they do get it, they may be more likely to have severe symptoms or even to die.
In general, the more health conditions someone has (for example, diabetes and heart disease), the higher their chance of becoming seriously ill from COVID-19. Your risk of getting very sick is likely to be lower if your diabetes is well managed.
Q. Do I need to worry about DKA if I get COVID-19?
A. When sick with a viral infection, people with diabetes, especially those with type 1 diabetes, face a higher risk of DKA. If your blood glucose is higher than 240 mg/dL for more than two checks in a row, check for ketones. Call your doctor’s office right away if you have medium or large ketones (or if you have been told to call with even trace or small ketones). DKA can make it challenging to get enough fluids and electrolytes, but doing so is important for avoiding sepsis, a serious complication of COVID-19.
Q. Is COVID-19 different from seasonal flu?
A. Yes. All of the routine safety measures you would take to avoid illness are even more important when dealing with this virus.
Q. What warning signs should I be watching out for, and what should I do if I have them?
A. Watch for possible COVID-19 symptoms such as fever, dry cough, and shortness of breath. If you have them, call your doctor.
• Have your blood glucose reading available.
• Have your ketone reading available.
• Keep track of how much fluid you are drinking and tell the doctor.
• Be able to clearly describe your symptoms. Are you nauseated? Coughing? Do you just have a stuffy nose?
• Ask about how to manage your diabetes while sick.
• Ask about options for seeing a doctor through telehealth (over a computer or smartphone) if you need care.
Q. What are the emergency warning signs, and what should I do if I experience them?
A. Get medical attention immediately if you have:
• 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 at home?
A. In the home of a person with a health condition such as diabetes, healthy household members should act as if they could give the less healthy person COVID-19, even if they feel fine. They should wash their hands before feeding or caring for them and clean all utensils and surfaces regularly. If possible, people at high risk should have a protected space at home. If someone in your home gets sick, give them their own room, if possible, and keep the door closed. Learn more about how to keep your home safe online at https://www.cdc.gov/coronavirus/2019-ncov/downloads/workplace-school-and-home-guidance.pdf.
Q. Will COVID-19 affect my access to insulin and other diabetes supplies?
A. So far, manufacturers report that COVID-19 is not affecting their ability to make and distribute insulin and other diabetes supplies. If you are struggling to pay for insulin or know someone who is, the American Diabetes Association has resources to help. Learn more online at InsulinHelp.org.
Q. Do I have special legal rights as a person with diabetes during the COVID-19 pandemic?
A. Yes. More information is available online at https://bit.ly/3c2X92g.
This handout was published in Clinical Diabetes, Vol. 38, issue 3, 2020. Visit the Association’s Patient Education Library at professional.diabetes.org/PatientEd for hundreds of free, downloadable handouts in English and Spanish. Distribute these to your patients and share them with others on your health care team.