Diabetes—type 1 and type 2—is a disease that occurs when your blood glucose or blood sugar levels are too high, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). This happens when your body doesn’t make enough (or any) insulin, a hormone produced by the pancreas to help your body get glucose from the food you eat into your cells, which then use it for energy. When your body can’t move the glucose from food into your cells, it builds up in the blood, which can lead to health problems like heart disease, stroke, and kidney disease, among others.
Those elevated or fluctuating blood glucose levels is part of why people with diabetes are at an increased risk for serious illness from Covid-19—and, according to Maria Pena, MD, director of endocrine services at Mount Sinai Doctors Forest Hills, these risks exist for those with type 1 and type 2 diabetes (though those with type 1 diabetes may be more sensitive).
The International Diabetes Foundation (IDF), adds that when those with diabetes develop a viral infection of any kind (including Covid-19), it can be harder to treat for two reasons: The person’s immune system is compromised, making it harder for their body to fight off the virus and can lead to a longer recovery period; and that viruses may thrive in environments with elevated blood glucose levels.
Those with diabetes also have heightened levels of inflammation throughout their bodies, which can put those with diabetes at a heightened risk as well, says Dr. Pena. “If you have a viral infection, that can turn into pneumonia easier, because diabetes itself is an inflammatory disease,” she says. It’s also important to note that, when a person has diabetes, episodes of stress, like a viral infection, can increase blood sugar levels, which can also lead to complications.
What should people with diabetes do to protect themselves from Covid-19?
While everyone should be taking precautionary measures during a viral outbreak regardless of any pre-existing conditions, the IDF says preventive measures are doubly important for those living with diabetes or those who have close contact with anyone who has diabetes. Those basic preventive measures (that, again, everyone should be doing right about now) include washing your hands thoroughly and frequently, avoiding touching your face as much as possible, cleaning and disinfecting frequently touched surfaces, and avoiding close contact with those showing symptoms of a respiratory illness.
There are, however, a few extra precautionary measures those with diabetes can take, according to the IDF. First and foremost, it’s important to pay close attention to your blood glucose levels—according to the IDF, any type of infection can raise blood sugar levels and increase your need for water, so it’s wise to have a sufficient supply. Those with diabetes should also make sure they have enough medication and testing supplies to last them for at least a month, in case of a quarantine or isolation situation. The same goes for a supply of food, and the ability to correct a drop in blood glucose quickly. Outside support is also essential, per the IDF, which recommends that those around you are aware of your condition and that you may require assistance if you become ill.
Dr. Pena adds that those with diabetes should be extra stringent about social distancing, or avoiding situations with lots of people in an enclosed space. “As a diabetic, I would avoid supermarkets or other public gatherings,” she says. It’s also wise for diabetes—and the general population—to be aware of the symptoms of Covid-19, like fever, shortness of breath, dry cough, and fatigue.
What should you do if you have diabetes and are diagnosed with Covid-19?
If you begin feeling symptoms of Covid-19 and may have been exposed, it’s especially important for those with diabetes to contact their doctor. If you end up testing positive for coronavirus, Dr. Pena says it’s important to begin and continue supportive care, which includes taking medications to calm symptoms, staying hydrated, and getting lots of rest.
Past that, however, there are extra steps diabetics diagnosed with COVID-19 should take, like increasing the frequency with which you check your blood glucose levels. “Sometimes an infection will naturally raise your blood sugar,” says Dr. Pena; this may even be the first sign of an infection for some. Because of that, it’s wise to keep in touch with your doctor regarding you medications. “The risk of severe high sugars and severe low sugars are possible so their medications need to be adjusted,” she says.
It’s also imperative that you keep an eye on your symptoms and inform your doctor of any changes. Immediately call your doctor if you start experiencing any severe symptoms, including difficulty breathing or shortness of breath, persistent pain or pressure in the chest, new confusion or inability to arouse, and a bluish tint to lips or face, per the American Diabetes Association.
One thing you (and anyone around you) shouldn’t do, however, is panic. The CDC and WHO, maintain that the best thing to do is stay informed about new developments surrounding coronavirus, and heed their advice, along with the advice of any doctors you meet with—whether it’s to prevent the illness or hasten your recovery.
