Diabetes & Coronavirus COVID-19
Written by Dr Mark Vanderpump, Endocrinologist
How does COVID-19 affect me if I have diabetes?
When you become ill with any infection, such as COVID-19, this can make your blood sugar levels rise as your body is less responsive to insulin and you cannot produce sufficient insulin to cope.
Am I more likely to be infected if I have Diabetes?
For most people, COVID-19 is a mild illness with a persistent cough, fever and shortness of breath, but some develop a more serious form of the virus which is potentially fatal. If you have diabetes, you may be at an increased risk of becoming infected with COVID-19 as well as developing more severe illness.
According to current government guidance you should be carefully following social distancing measures, including significantly limiting face-to-face interaction with friends and family if possible.
Are the risks different for COVID-19 for people with type 1 or type 2 diabetes?
The risks appear low in young people with type 1 diabetes who have good blood sugar control. However, older people with type 1 diabetes or those with type 2 diabetes, who tend to be older and have other conditions such as hypertension or heart disease, are at increased risk.
Are people who get COVID-19 who have diabetes more likely to have serious complications from COVID-19?
Everyone with diabetes, including those with type 1 and type 2, is more at risk of severe lung complications if they develop COVID-19. Try not to panic; stress will after all affect your blood sugar levels.
It is important to remember that not everyone with diabetes has been severely affected. BBC News talked about type 1 diabetes patient Andrew O’Dwyer who contracted COVID-19 in Italy. He had a cough and a high temperature but has fully recovered. More details here
Actor Tom Hanks has type 2 diabetes and revealed he had contracted COVID-19 in Australia via an Instagram post on March 11th. He described his symptoms as being fatigue, body aches and slight fevers but has now left the hospital and is in self-isolation with his wife. He says he feels what he calls the “blahs” in other words, just a bit under the weather. You can read the update here
Should I stop taking certain medications because I’ve heard that some drugs may affect my risk of COVID-19 infection?
There have been reports that a medication used to lower blood pressure (ACE-inhibitors) is associated with more severe complications but that is likely to represent a risk due to the hypertension rather than the drug used to treat hypertension. Another report (mentioned by the French Health Minister) linked non-steroidal anti-inflammatory drugs such as Ibuprofen with a worse outcome.
The Chief Scientific Officer, Sir Patrick Vallance, recommended Paracetamol for viral symptoms as a precaution until this was confirmed.
Is the supply of insulin likely to be affected by COVID-19?
There are no reported issues with the supply of insulin so there is no need to “hoard” supplies.
How can I prepare in the event I become infected and have diabetes?
In order to remain well when you have diabetes, it is important to manage the condition in a vigilant way so that you avoid fluctuating blood sugars. This is the same advice in the current situation except that you could benefit from more frequent testing of your blood sugar levels.
When you are ill any carbohydrate you may eat may have two or three times the impact that you are used to it having so you should lower your intake, stay well hydrated and keep up that monitoring. You should implement your sick day rules and know what to do with your medication.
Do make sure you have an adequate supply of insulin, test strips, pump supplies and tablets.
If you have type 1 diabetes, you will need to check your blood sugar more regularly, including during the night, and check your ketones if your blood sugar level is high (generally 13-15mmol/l or more). If ketones are present, contact your diabetes team.
Keep eating or drinking – if you can’t keep food down, try snacks or drinks with carbohydrates to give you energy. If you’re vomiting, or not able to keep fluids down, get medical help as soon as possible.
There is good advice about keeping control of diabetes during illness on the diabetes.co.uk website
If you feel you cannot cope with your symptoms at home, or your condition gets worse, or your symptoms do not get better after 7 days, then use the NHS 111 online coronavirus service. If you do not have internet access, call NHS 111. For a medical emergency, dial 999.
Read official guidelines for Coronavirus COVID-19 from the NHS here