Living with Diabetes in a Coronavirus Pandemic

COVID-19 has the potential to increase health complications in people with diabetes, whether type 1 or type 2. Here’s what these individuals need to know.

If you’ve been keeping up with federal guidance on who’s at higher risk for complications from COVID-19, you know that people with diabetes are among the affected groups. People older than 60, along with those who have respiratory problems, high blood pressure, and heart disease are, too, notes the Centers for Disease Control and Prevention (CDC).

People with type 2 diabetes may have a higher risk of COVID-19 complications and death than those with type 1, but those with type 1 should still prioritize their health during this time. 

Understanding COVID-19 and Its Symptoms

According to the World Health Organization (WHO), coronaviruses are a large family of viruses that cause diseases including the common cold, but also more severe illnesses, such as Middle East respiratory syndrome (MERS); severe acute respiratory syndrome (SARS); and COVID-19, which first became known at the end of 2019 during an outbreak in the city of Wuhan in China’s Hubei province and has since developed into a pandemic. As of now, there is no vaccine or cure for the coronavirus that causes COVID-19.

Common symptoms of COVID-19 include fever, tiredness, dry cough, aches and pains, nasal congestion, runny nose, sore throat, and diarrhea, the WHO reports. Some infected people have no symptoms at all, but they can still spread the virus.

A mysterious rash on the toes, dubbed "COVID toes," may also be a sign of COVID-19, suggested an early study published in May 2020 in Pediatric Dermatology. Typically though, this is a natural immune response in healthy people, and may signal that the individual is recovering or has recovered from the disease.

For most people the disease is mild, and about 80 percent of those infected recover from COVID-19 without needing hospitalization or special treatment. Yet around 1 out of every 5 infected people do become seriously ill, develop difficulty breathing, and require hospital care. While estimates for the death rate vary, even at a low-end estimate of 1 percent, COVID-19 is 10 times more deadly than the seasonal flu, says Anthony Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases (NIAID), as reported by CNBC.com.

If you have fever, cough, and difficulty breathing, WHO advises you to seek medical attention. Stay at home and call your doctor. Don’t go to an emergency room unless you are having a medical emergency, in which case you should call 911, advises the CDC. The agency describes the emergency warning signs for COVID-19 in adults as difficulty breathing or shortness of breath; persistent pain or pressure in the chest; new confusion or inability to arouse; and bluish lips or face.

Given all that, if you have diabetes and wish to stay in the best health possible during this pandemic, experts have some advice.

1. Follow the CDC Guidelines for Everyone

• Clean your hands often with soap and hot water or sanitizer that is at least 60 percent alcohol.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact and practice social distancing (staying at least six feet apart).
• Cover coughs and sneezes with a tissue. (Then clean your hands!)
• Clean and disinfect frequently touched surfaces daily, and dirty ones immediately.
• Stay home if you’re sick.
• Separate yourself from others if you have been diagnosed with COVID-19 or think you have it.
• Wear a face mask outdoors.
• Call ahead about medical attention unless you are having a medical emergency.

Of course, in this fast-moving pandemic, local and government regulations and guidelines are constantly shifting regarding meetings, gatherings, travel, working, and when you should stay at home. Follow the latest ones, as they are meant to slow the spread of the virus.

2. Keep Your Diabetes Treatment Supplies and Equipment Clean and Disinfected

Please keep up hygiene at home, keep washing your  hands. For patients with diabetes, it is important to wash your hands thoroughly before administering insulin or injectable medications. You should also use soap and water to clean the areas on your body where you inject your medication. DO NOT share needles or pens, and to dispose of needles safely.

3. Keep Your Prescriptions Filled and Stock Up on Extra Supplies

Ensure that you have all your medications — not only the medications to treat diabetes but the medications to treat hypoglycemia. Having extra glucose tablets in case your blood sugar drops too low. People who take insulin should have backup insulin pens (or syringes and vials) if needed.

As for how much you should stock up on: The CDC recommends a 14-day self-quarantine period for anyone exposed to the coronavirus, so to be safe, at least several weeks' to a month’s supply of medications on hand is recommended. 

4. Check for Measures That Make It Easier to Get Those Extra Supplies 

If you are worried about the possibility that your prescription coverage won’t allow early refills, check with your pharmacy. Now that a national emergency has been declared, many insurers have increased allowances for [number of] days' supplies or early refills for chronic care  medications for underlying medical conditions such as diabetes and high blood pressure.

5. Know That Some Over-the-Counter Medication Can Affect Blood Glucose

Some over-the-counter drugs used to treat cold and flu symptoms may affect your blood sugar levels.

These include:

• Cough syrups, except those that are labeled sugar-free
• Pills that contain the same ingredients as syrups and do not have carbohydrates
• Decongestants such as phenylephrine and pseudoephedrine
• Aspirin in large doses
• Advil (ibuprofen), which can increase the hypoglycemic effect of insulin

Ask your healthcare provider if you are not sure about the effects of an over-the-counter medication.

6. Be Vigilant for Signs of Unstable Blood Sugar or DKA, Especially if Insulin or Other Drugs Run Low

People with type 1 diabetes, and, in rare cases, long-standing type 2 diabetes, are vulnerable to developing a potentially life-threatening condition known as diabetic ketoacidosis (DKA). When the body doesn’t have enough insulin to convert glucose into energy, it begins to break down fat to use as fuel. The result is a buildup of acids in the bloodstream known as ketones.

Diabetics need to check their ketones at home if they are experiencing persistent hyperglycemia to make sure they don’t go into DKA, regardless of whether they have any symptoms. This can happen in patients that miss injections or that have failures in their pumps or any problems getting access to insulin. They need to go to the doctor.

7. Maintain a Healthy Lifestyle by Prioritizing Diet, Exercise, and Sleep

With gyms closed and many sports activities postponed, it can be a challenge to stay on the healthy regimen you established before the pandemic. Some people become sedentary when they stay at home. If you are not under quarantine or otherwise advised to stay at home, go for a walk outside (while maintaining social distancing guidelines). If you are home bound, what a workout exercise video. There are plenty of free resources to help you exercise online. 

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BETTER HEALTH & BEYOND Editorial Team

At Phillips Pharmacy Online our vision is to be an integral part in transforming the way that healthcare is delivered in Barbados & beyond. We are a group of passionate people working hard to make a big positive impact on the lives of people. We work with Doctors, Pharmacists, Pharmaceutical Suppliers and most importantly, with You, to improve the health of all.

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Disclaimer of Medical Advice:

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