People with diabetes may have an increased risk of developing COVID-19. What do we have to do:

  • People with diabetes should purchase a 90-day supply of insulin, as well as exercise, eat healthy, wash their hands, and keep their distance during an outbreak.
  • Experts say people with diabetes may be at higher risk of developing COVID-19 complications than the general population, although the study is not conclusive.
  • Experts recommend that people with diabetes prepare for a possible infection by purchasing a 90-day supply of insulin.
  • They say that people with diabetes should wash their hands, keep their distance and practice self-isolation, which is what the entire public is being asked to do.

People with diabetes are among the groups most at risk of developing serious complications from the new coronavirus and its illness, COVID-19. You can also read everything about coronavirus in our articles.

That’s about 1 in 10 Americans who should think about how to manage diabetes while in lockdown and reduced social contact, and how to take care of themselves if they feel like they’re getting sick.

People over the age of 60 with diabetes and other health problems are particularly at risk, the American Association of Clinical Endocrinologists (AACE) said in a statement.

“Recent studies have shown that among those who were hospitalized with a severe condition, 22.2% to 26.9% suffered from diabetes,” they wrote. “Diabetes and high glucose levels are associated with increased complications, respiratory failure, and mortality in hospitalized patients with COVID-19.”

Diabetes and risk of COVID-19

Researchers are not sure why people with diabetes may have a higher risk of complications and death from COVID-19, or if there is such a risk at all.

For example, a study of more than 72,000 cases of COVID-19 in China, published in the journal JAMA, found that people with diabetes have a mortality rate three times higher than people without diabetes – about 7 percent compared to about 2 percent.

While other studies have confirmed this, there are other studies that draw different conclusions. The COVID-19 disease is still new, so knowledge about it is limited and is only being collected.

According to Heather de Vries McClintock, Ph.D., assistant professor of public health at Arcadia University of Pennsylvania, the obvious risk for people with type 1 diabetes, as well as for people with type 2 diabetes who take ACE inhibitors as part of the the treatment prescribed by the doctor.

“People with diabetes, especially type 1, who are infected with the virus are more likely to have diabetic ketoacidosis, which inhibits the body’s ability to mitigate sepsis, which is the leading cause of death among people with COVID-19,” McClintock told Healthline.

In addition, she noted: “Pathogenic coronaviruses bind to target cells through angiotensin-converting enzyme II (ACE II). People with diabetes (both type 1 and type 2) who are treated with ACE inhibitors and type I angiotensin receptor blockers (ARBs) may have increased production of ACE II.”

How people with diabetes prepare for coronavirus

Knowing the risks, the question is how best to prepare for all this.

“The best option would be to purchase a 90-day supply of insulin if possible. It’s best to order refills as soon as possible rather than waiting for stocks to run low,” said Ashlyn Smith, a medical assistant at the Endocrinology Association in Scottsdale, Arizona, and president of the American Society of Endocrinological Medical Assistants.

“In places where a state of emergency has been declared, people with diabetes can get an additional 30-day supply of drugs and supplies,” she said.

If you can’t get extra medicines this way, try mail-order medicines, says Dr. Olufanmilayo Abidemi Onobrakpeya, medical director of the University of Maryland Center for Diabetes and Endocrinology at Upper Chesapeake Medical Center.

Also, if you have appointments or out-of-home doctor visits, consider changing your schedule or see if you can use the internet for these purposes, Onobrakpeya told Healthline.

In addition to insulin, people with diabetes should prepare for the coronavirus just like everyone else: pay special attention to thorough handwashing, surface disinfection, social distancing and self-isolation.

In addition, physicians writing in the journal Diabetes and Metabolic Syndrome: Clinical Studies and Reviews recommend the following specific recommendations for people with diabetes in preventing infection:

  • Maintain careful glycemic control. This can help in reducing the risk of infection as well as the severity of the disease. Constantly monitor your blood glucose levels.
  • Proper nutrition. It is important to pay attention to nutrition and adequate protein intake, and to avoid mineral and vitamin deficiencies.
  • Workout. Training can improve immunity, but it is better to choose a safe type of activity like running outside. Do not go to the gym and do not attend other group classes.
  • Get vaccinated against flu and pneumonia. The latter especially may reduce the likelihood of secondary bacterial pneumonia after a respiratory viral infection (although the researchers note that data on the current viral epidemic is lacking).

Finally, AACE offers a free Diabetes Emergency Plan that people can use as a checklist and resource center to fight COVID-19.

What to do if you suspect you have a coronavirus infection

If you have diabetes and think you may have contracted the novel coronavirus, the first step is to contact your doctor and local health department and prepare for self-quarantine (or be quarantined in a hospital), the researchers note.

If you self-isolate, the American Diabetes Association (ADA) recommends that you make sure you have enough fluids to keep you hydrated. Track your fluid intake and check your glucose and ketone levels.

“Check your blood sugar throughout the day and night (usually every 2-3 hours; if you use CGM, monitor constantly)” according to the ADA. “If blood sugar has been high (BG above 240mg/dL) more than 2 times in a row, check for ketones to avoid diabetic ketoacidosis.” You can also find out about the prevention of coronavirus infection on our website.

While some of this sounds scary, experts say it’s important to take extra precautions for COVID-19. In addition, if you have symptoms, start treatment as if you had a serious flu.

“Make sure you have over-the-counter medicines and medicines to deal with fever and other symptoms,” Onobrakpeya said. “Most people will be able to recover from COVID-19 at home.”

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