Diabetes and COVID-19
How to prepare for the Coronavirus with diabetes
Written by Lisa Marie Basile
As a caregiver for someone with diabetes or a diabetic yourself, you might be wondering if COVID-19 poses an extra threat to your health. Here’s what you can do to prepare and stay safe, especially if you’re living in a Coronavirus hot zone.
Even though you’re already used to living cautiously or being hyper-vigilant of your body’s unique needs, times like these can be extra anxiety-inducing. It’s entirely valid to be concerned about all of the unknowns and what-if’s involved with a highly contagious novel virus. So, let’s get down to business.
What we know about COVID-19
First, here’s what we do know about COVID-19. According to the World Health Organization, the virus comes from a family of Coronaviruses (CoV) humans have dealt with before. Coronaviruses have caused everything from the common cold to the well-known Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). This new version, though? It’s a novel strain (nCoV) discovered in 2019, transmitted between both animals and people. The incubation period is 2-14 days after exposure.
The core symptoms? According to Harvard Health, respiratory issues may include cough, nasal congestion, shortness of breath, and pneumonia. Infected people may also experience fever, body aches, and sore throat. Additionally, kidney failure, organ inflammation, or Acute Respiratory Distress Syndrome, in which the lungs fill with fluid, may occur. There’s also evidence that this virus can attack the gastrointestinal system, so indigestion and diarrhea is also possible—although this still does not explain the toilet paper hoarding we’ve seen as of late. In severe cases, complications can be fatal. The majority of deaths have occured in people over the age of 60, with pre-existing conditions (more on that below).
More deadly than the flu
So how does all of this impact diabetics? For one, The American Diabetes Association says COVID-19 is proving to be more serious than the seasonal flu for diabetics — so you’ll want to proceed with care.
The World Health Organization (WHO) warns that the most at-risk populations are: “older persons and persons with pre-existing medical conditions (such as high blood pressure, heart disease, lung disease, cancer or diabetes).” People with these conditions seem to develop more serious illness when they contract the virus.
Recently, beloved American actor Tom Hanks, who is a type 2 diabetic, was diagnosed with Coronavirus. He explained in an Instagram post that he experienced tiredness and body aches, but said he was fine and that he was quarantining himself to avoid giving it to others. Although his case seems fairly mild, news reports like that are sparking further conversation around how the novel virus may affect people with diabetes.
Diabetes—both type 1 and 2—are a family of diseases that result in too much sugar in the blood (otherwise known as high blood glucose). When your body doesn’t make any or enough of the hormone insulin, which aids in your body getting glucose into your cells for energy, the glucose builds up in the blood. Many diabetics take insulin to help manage those glucose levels.
In type 1 diabetes, the immune system attacks the cells in the pancreas that make insulin. In this case, you’ll need to take insulin every day. In type 2 diabetes, the body doesn’t make enough of or appropriately use the insulin it has. This is the most common form of diabetes.
Diabetes can increase risk of contraction of COVID-19
When it comes to infections, both diabetes type 1 and 2 can increase your risk of contraction. According to Current Diabetes Review, type 2 diabetes can “increase the incidence of infectious diseases and related co-morbidities,” although more research is needed. Diabetes type 1 also increases risks for morbidity and mortality, according to other studies.
Diabetics have higher rates of complication and death from COVID-19
When it comes to COVID-19, The American Diabetes Association explains, “In China, where most cases have occurred so far, people with diabetes had much higher rates of serious complications and death than people without diabetes.”
But why might COVID-19 and other viruses be so risky for diabetics? Let’s dive in.
Disfunction of the immune response makes diabetics more susceptible to infections
For one, it’s thought that hyperglycemia (which occurs when you have high levels of sugar, or glucose, in the blood) in diabetics may be a cause of dysfunction of the immune response, which results in failure to control the spread of invading pathogens in diabetic subjects, making diabetics more susceptible to infections, according to a study published in Current Diabetes Review.
Damage to the circulatory system slows healing
Sarah Sato, NP, CDE for The Alpine Center for Diabetes, Endocrinology, and Metabolism, explains further: “Some diabetes patients have damage to their circulatory system, which slows the healing effects of the blood from getting to and from those areas.”
Sato also said that some diabetics might experience delayed healing. When someone with diabetes is fighting off an infection, for example, it leaves the body vulnerable. Sometimes, she says, if the body is experiencing inflammation related to uncontrolled high blood sugar, “then the inflammatory response of the body can slow the immune response to new threats.”
To make matters a little less complicated, though, there probably isn’t too much of a difference in how the virus plays out in people with type 1 versus type 2 diabetics, according Dr. Robert Gabbay, Chief Medical Officer, Joslin Diabetes Center in Boston, the global leader in diabetes research, care and education.
While diabetics and other chronically ill people or their families may feel especially overwhelmed right now — don’t worry, you’re not alone — taking action can help.
Stock up on a few weeks worth of medical supplies and insulin
Dr. Gabbay recommends stocking up on medical and food supplies. This might include extra bottled water (which is necessary in the case of increased blood sugar levels), rubbing alcohol, ketone strips, glucagon, and foods like Jell-O and hard candies for when you’re too ill to eat but need a bit of sugar. You’ll also want to make sure you have enough medication available to manage your diabetes.
Make a virtual medical plan in case you are quarantined
If you’re using insulin, you’ll need at least the week ahead’s supply, and you’ll need to know how to adjust your insulin doses to maintain healthy blood sugar levels. If you’re quarantining yourself or planning to, it’s a smart decision to get your refills arranged with your local pharmacy and to be in regular communication with your healthcare provider. Even better? Check with your doctor to see if they can provide virtual visits or other digital check-ins, as well.
While all of this sounds pretty apocalyptic, Sato offers a friendly warning: “It doesn’t make sense to stockpile so much medication that it ends up going bad. A few extra weeks ought to be enough —and most diabetics try to keep their supplies filled like this anyway.”
Practice social distancing
You’ll want to make sure that you’re practicing social distancing at this time — only leaving the house when it’s absolutely necessary, and leaving about six feet between you and strangers. The virus spreads fairly easily — through infected surfaces (think door knobs and faucets) as well as from droplets from other infected people coughing and sneezing.
What if, after preparing your household, practicing social distancing, and quarantining yourself, you think you may have contracted the COVID-19? Be sure to follow the CDC guidelines: Call your doctor, stay home, limit contact with people and animals, and wash your hands well and often (just make sure to dry them carefully so there’s no residue on your fingers before you prick your finger when checking blood glucose). The CDC suggests washing them with soap and water for a full 20 seconds.
Your self-care during sickness should mimic what you’ve done in cases of the cold or a flu, Sato says. Get plenty of rest, reach for your H20 all day, eat well, and continue to monitor your blood sugar levels, which can be more unpredictable when ill.
You’ll definitely want to seek medical attention if you’re having trouble breathing or if your illness gets worse. The CDC says, “Persons who are placed under active monitoring or facilitated self-monitoring should follow instructions provided by their local health department or occupational health professionals, as appropriate.”
If you live alone and are unwell things can get a bit trickier. According to Dr Laurence Gerlis, CEO & Lead Clinician at SameDayDoctor, you’ll want to think about who you’ll contact in an emergency: “Make sure friends and relatives are available to you by telephone,” he says. “This is especially important for people who are living alone who may need to self-isolate.”
Have an emergency contact on speed dial
In general, it’s a good idea to have a friend, family member, or trusted neighbor on a proverbial speed-dial so that they can bring you groceries or call your doctor in case you’re unwell. They should be someone who understands your history of diabetes and can help you if you need it.
Whether we’re dealing with COVID-19 or not, it’s smart to be prepared. Diabetes is a tricky disease and can cause complications, but staying informed, being prepared, and having a helping hand can make all the difference.