As the world continues to reel from the coronavirus pandemic and new cases of COVID-19 (the disease caused by the virus) multiply daily in the United States, people with diabetes are understandably worried about how to protect their health. The U.S. Centers for Disease Control and Prevention (CDC) has stated that certain groups — including older people and people with diabetes — have an elevated risk of severe illness from the infection, and should take special precautions to limit their infection risk.
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The risk that COVID-19 poses to people with diabetes is highlighted by a study from China that examined virus-related death rates among various groups. Published in the journal JAMA, the study found that the case fatality rate (CFR) of COVID-19 in February was 2.3% overall, but higher in certain groups of people with health conditions: 10.5% for people with cardiovascular disease, 7.3% for people with diabetes, and 6.3% for people with chronic respiratory disease. In addition, the CFR for people over age 80 was 14.8%, and in people ages 70–79 it was 8.0%.
Of course, age and health conditions aren’t completely separate risk factors for death or severe illness from COVID-19 — the numbers for older people reflect the higher rate of chronic diseases in this group. Further complicating the picture, people with diabetes often have other health conditions, so it’s unknown how much of the increased risk for COVID-19 is due to diabetes alone.
In fact, guidelines from the CDC, as well as statements from many medical experts, suggest that people with diabetes should focus on controlling their condition as well as possible to protect themselves from the new coronavirus. According to the CDC, people with diabetes — and those with chronic kidney disease or liver disease — are at a higher risk for severe illness particularly if these conditions are not well controlled.
A recent Medscape article highlights the importance of diabetes control to help prevent severe cases of COVID-19. That’s because high blood glucose levels can disrupt the function of white blood cells, which play a critical role in fighting off infections. In fact, many experts quoted in the article state that when it comes to coronavirus preparedness and risk, people with well-controlled diabetes probably aren’t that much different from the general population.
Still, the reality is that many people with diabetes aren’t able to achieve optimal blood glucose control and should take extra steps to limit their infection risk — measures like staying at home, washing your hands often, cleaning and disinfecting frequently touched surfaces, and avoiding contact with sick people. It’s also important to have a plan and backup supplies in case you do get sick.
If you’re not feeling well, it’s important to call your doctor to have your symptoms evaluated. Your doctor can then tell you whether it’s best to stay home to recover, or whether you need urgent medical care. If you’re managing your illness at home, it’s important to test your blood glucose more frequently, since illness can make your glucose spike unpredictably. If your glucose levels get above a certain level — typically 250 mg/dl — you should test for ketones, according to the advice of your healthcare provider. And don’t forget to stay hydrated, and take over-the-counter drugs for fever, like acetaminophen (Tylenol), with caution.
If you’re taking acetaminophen, the Medscape article notes, be aware that the drug may interfere with the accuracy of continuous glucose monitoring (CGM) systems. It’s important to confirm those readings with traditional finger-stick tests.
If you’re at home sick with COVID-19 or anything else, be sure to call your healthcare provider if your symptoms get significantly worse, including if you have trouble breathing.
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.”