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Coronavirus and Diabetes: A COVID-19 Update

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Coronavirus and Diabetes: A COVID-19 Update
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We’ve been living in a pandemic for several months now and our new “normal” is anything but normal. Coronavirus is surging in several states, more and more people are wearing masks, and there’s constant talk in the news about possibly having a vaccine against COVID-19 by the end of the year. Coronavirus hasn’t gone away — and probably won’t — but strides have been made in learning more about the virus, as well as newer treatments.  

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A quick coronavirus recap 

Coronavirus, also known as SARS-CoV-2, is a new virus that first made its appearance in late 2019 in Wuhan, China. There are different types of coronaviruses; in fact, coronaviruses are pretty common and tend to cause only mild illness in humans. This novel (new) coronavirus causes COVID-19, the disease caused by the SARS-CoV-2 virus. 

How COVID-19 is spread 

COVID-19 is spread among people who are within approximately 6 feet of each other via respiratory droplets produced when an infected person talks coughs, sneezes or talks. These droplets can end up in a person’s mouth or nose and be inhaled into the lungs. The longer a person interacts with another person (or persons) who are infected with the virus, the higher the risk of getting COVID-19 and the higher the risk of spreading it to others.  

Can COVID-19 be transmitted by touching surfaces?

The virus can last up to three days on metal and plastic surfaces, and on cardboard for 24 hours. However, the chances of a person becoming infected with the coronavirus after touching a surface depends on several factors. First, there would have to be enough of the virus on the surface in order to cause an infection. And second, the person would need to pick up enough of the virus and touch their mouth, nose or eyes. To be on the safe side, the CDC (Centers for Disease Control and Infection) recommends regularly cleaning surfaces that you come in contact with, such as doorknobs, railings, counter tops, bathrooms fixtures, light switches, phones, laptops and tabletops.  

 Is coronavirus airborne?

According to the CDC, “COVID-19 can sometimes be spread by airborne transmission.” Their website states, “Some infections can be spread by exposure to virus in small droplets and particles that can linger in the air for minutes to hours. These viruses may be able to infect people who are further than 6 feet away from the person who is infected or after that person has left the space… There is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than 6 feet away. These transmissions occurred within enclosed spaces that had inadequate ventilation.” Being indoors raises the risk of inhaling the virus. Opening the windows as much as possible is a good idea to increase air circulation. 

Is coronavirus transmitted by food?

Unfortunately, it’s not yet clear if the virus is transmitted this way. It’s possible that someone who is infected with the virus could cough or sneeze on food that they have prepared or handled. The risk of infection is greater if you eat food prepared by someone else. If you are preparing food for yourself and your family, always wash your hands with soap and water for at least 20 seconds before you prepare or eat food. 

 Is coronavirus transmitted in water?

Another common concern you might have is if coronavirus is spread in water. After all, taking a dip in a pool, a lake or the ocean sure beats the heat during the hot summer months. The good news: There’s no evidence that the coronavirus can be spread via water. However, you still need to practice social distancing if you’re bobbing in the water or lying on the beach. In or out of the water, stay at least 6 feet away from others; wear a face covering when you’re not in the water; don’t touch your face; avoid sharing beach toys, towels, and food with others who don’t live with you; and wash your hands (or use hand sanitizer) before eating. Avoid crowded swim areas, water parks and playgrounds, and hot tubs that don’t have measures in place to keep people safe. 

Symptoms of COVID-19 

According to the CDC, symptoms of COVID-19 may appear two to 14 days after exposure, which means that a person may spread the virus for days or weeks before having any symptoms. Symptoms include:   

  • Fever 
  • Cough 
  • Shortness of breath or difficulty breathing 
  • Fatigue  
  • Muscle or body aches 
  • Headache 
  • New loss of taste or smell 
  • Sore throat 
  • Congestion or runny nose 
  • Nausea or vomiting  
  • Diarrhea 

The severity of symptoms can range from very mild to severe and can even be deadly. Pneumonia may occur in people with COVID-19 infection. Severe cases of COVID-19 have occurred in men and women over the age of 50 and in those with other health conditions. 

If you develop any of these symptoms, especially if you have traveled from an area with ongoing spread or have been in contact with someone who has COVID-19, contact your healthcare provider. Your provider will likely test you for COVID-19Some tests are point-of-care tests, meaning results may be available at the testing site in less than an hour. Other tests must be sent to a laboratory to analyze, a process that takes one to two days once received by the lab. 

Who is at increased risk of COVID-19?

The risk of getting COVID-19 increases with increasing age, especially for those who have underlying medical conditions. Currently, the strongest evidence links the following conditions with acquiring COVID-19: 

  • type 2 diabetes 
  • chronic kidney disease 
  • COPD (chronic bronchitis or emphysema) 
  • obesity (body-mass index [BMI] of 30 or higher) 
  • immunocompromised state (weakened immune system) from solid organ transplant 
  • serious heart conditions, including coronary artery disease, heart failure and other diseases of the heart muscle 
  • sickle cell disease 

Other conditions that may increase the risk of COVID-19 include: 

The risk of getting COVID-19 is higher in certain racial and ethnic groups, including native Americans, Alaska Natives, Black Americans and Hispanic Americans; as well as in people who live in nursing homes or long-term care facilities; people who are homeless; and people with certain developmental and behavioral disorders such as autism, cerebral palsy and attention deficit hyperactivity disorder (ADHD). 

Managing COVID-19 

Most people who become ill with COVID-19 will have a mild illness and usually recover in one to two weeksMore severe cases can take six weeks or longer to recover. Seek immediate medical care if you have any of the following symptoms: 

  • Trouble breathing  
  • Ongoing pain or pressure in your chest 
  • Blueish lips or face 
  • Confusion 
  • Inability to wake up or stay awake 

If you are diagnosed with COVID-19, you’ll need to isolate yourself from others in your household, not share items such as dishes and towels, stay in a separate room (if possible), wear a face covering when around others, and not leave your home unless you need medical care.  

Treatments for COVID-19 

Currently, there is no vaccine for COVID-19 but scientists are working on developing one with the hope of possibly having a vaccine by the end of this year. There is also no treatment specifically approved for people who have COVID-19. Other medications may be used to help treat symptoms, though, including: 

  • Acetaminophen: Used to treat fever, aches and pains.
     
  • Convalescent plasma: Plasma that contains antibodies from people who recovered from COVID-19 that is used for patients with serious or life-threatening illness. 
  • Dexamethasone: An anti-inflammatory drug used to decrease the risk of death in seriously ill hospitalized COVID-19 patients. 
  • Remdesivir: n anti-viral drug used for severely ill hospitalized COVID-19 patients 
  • Hydroxychloroquine and chloroquine: these drugs are used to treat malaria and autoimmune conditions. A few studies have shown that they may be helpful for hospitalized patients with mild COVID-19 but more studies are needed.  
  • Azithromycin: a common antibiotic that has been given in conjunction with hydroxychloroquine with some benefit, but more research is needed, and there are concerns about possible serious side effects when these two drugs are given together. 

A number of other medications are being used in clinical trials with high hopes of showing benefits. These include colchicine, a gout medication; oseltamivir (brand name Tamiflu), an antiviral medication used for the flu, tocilizumab used to treat rheumatoid arthritis; and ivermectin, used to treat parasitic infections.  

The FDA has not approved any treatments for coronavirus, but it has established a new program called the Coronavirus Treatment Acceleration Program (CTAP) to help speed up research on COVID-19 treatments. 

Treatment for mild symptoms of COVID-19 is primarily to self-isolate at home, whereas hospitalized patients receive oxygen and possibly off-label medications (listed above). 

Of note, there is some evidence that indicates vitamin D may prevent COVID-19 infection and serious symptoms of the disease. The RDA for vitamin D is 600 IU daily for adults 70 and younger, and 800 IU daily for adults over 70. Vitamin D supplements of 1000 to 2000 IU is safe for most people. Unfortunately, the same can’t be said of vitamin C: There is no evidence that this vitamin will prevent infection or lessen symptoms of COVID-19. 

What about COVID antibody tests?

Antibody testing is a blood test that can show if you have had the COVID-19 infection. The test is available through healthcare providers and laboratories. Speak with your provider if you think you should get one. However, keep in mind that results don’t confirm whether you can spread the coronavirus, so you still need to take steps to protect yourself and others. 

Slowing the spread of COVID-19 

While we wait for a vaccine, there are a number of important steps to take to lessen the spread of this virus.  

Social distancing

Now a household term, staying at least 6 feet away from people not in your household or from people in your home who are sick is extremely important, especially if you are at high risk from getting this disease. 

Wearing a face covering

Covering your mouth and nose with a cloth covering, such as a face mask, helps protect others around you from getting COVID-19 (and you can be a carrier of the virus even if you don’t feel ill). Face coverings don’t replace social distancing, however.  

Handwashing

Washing your hands often with soap and water for at least 20 seconds is also important, especially if you’ve been out in public, or have coughed, sneezed or blown your nose. 

Covering coughs and sneezes

Always cover your mouth and nose when you cough or sneeze; use a tissue or the inside of your elbow. Don’t forget to wash your hands afterwards! 

Cleaning and disinfecting surfaces

Every day, wipe down surfaces in your home (counter tops, tables, doorknobs, toilets, etc.) with a household disinfectant. 

Diabetes and COVID-19 

According to the International Diabetes Federation, people with diabetes “appear to be more vulnerable to becoming severely ill with the COVID-19 virus.” It’s harder to treat a viral infection in someone with diabetes because of glucose fluctuations and the presence of diabetes complications. In other words, if you have diabetes and become ill with COVID-19, you face worse health outcomes compared with someone who doesn’t have diabetes.  

High blood sugars can interfere with white blood cells’ ability to fight infection,” says Robert Gabbay, MD. The good news is that your risk of getting COVID-19 is lower if your diabetes is well-managed. It’s not always easy to do this, but now is the time to focus on ways to get and keep your blood sugars as close to your target range as possible.  

The CDC encourages people with diabetes to lower their risk of illness from COVID-19 by doing the following: 

  • Taking your diabetes medicines as usual. 
  • Checking your blood sugar regularly and keeping track of the results. 
  • Having at least a 30-day supply of diabetes medicine on hand. 
  • Following your sick-day plan from your provider if you feel ill. (No sick-day plan? Talk with your provider or diabetes educator about what to do if you become ill.) 
  • Calling your provider if you have concerns or if you become sick. 

Let your provider know if you are having trouble accessing your diabetes medication. Resources are out there that can help. For starters, visit the American Diabetes Association’s website www.insulinhelp.org. 

Interestingly, an international group of scientists now suspect that having severe COVID-19 can increase the risk of developing either type 1 or type 2 diabetes. Several cases of new diabetes have appeared in people who were infected with the coronavirus. The concern is that the coronavirus may damage the beta cells in the pancreas, which are the cells that produce insulinA global database has been established called the CoviDiab Registry to collect information on people with COVID-19 who develop high blood sugars and who don’t have a history of diabetes.  

Want to learn more about coronavirus and diabetes? Read “Coronavirus and Diabetes: What You Need to Know,” “Healthy Eating During Hard Times” and “Avoiding Coronavirus With Diabetes: Stock Up and Stay Home, CDC Says.”

 

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter, DiabeticConnect.com, and CDiabetes.com

 

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