Coronavirus and Diabetes – What You Should Know
Editor’s Note: This content has been verified by Anne Peters, MD. She is a professor of clinical medicine at the Keck School of Medicine of the University of Southern California and the Director of the USC Clinical Diabetes Programs. She runs diabetes centers in Beverly Hills and in underserved East Los Angeles. In addition, she serves on the Beyond Type 1 Science Advisory Committee.
The current outbreak of coronavirus (COVID-19) has caused a great deal of panic and has many questioning what it means for them. COVID-19 originated in China and has since made its way around the world, including in the United States. A few quick facts:
- By the numbers: over 31.6 million people infected, over 970,000 deaths, over 21.7 million recovered
- The virus has been detected in 188 countries, areas, and territories so far.
- On June 26, the United States saw an all-time high 40,000 coronavirus cases.
- On June 25, the CDC clarified the risks of severe outcomes from COVID-19 exposure, including pregnancy, sickle cell disease, serious heart conditions, Type 2 diabetes, and obesity.
- It is unknown whether or not people with diabetes are at more risk for catching the novel coronavirus. Once contracted, illnesses can be harder to treat because of fluctuations of glucose levels and the presence of other complications.
- Most of the reported deaths in people with diabetes had Type 2 diabetes, were older and had heart and/or lung disease. The biggest risk factors seem to be age and the presence of cardiovascular disease.
- In recent news: On May 4, CMS issued another round of changes to further expand care and make it easier for Medicare and Medicaid beneficiaries to get COVID-19 testing and access to telehealth
- On April 26, the CDC added 6 new symptoms for COVID-19: chills, repeated shaking with chills, muscle pain, headache, sore throat and new loss of taste or smell.
- On April 8, Abbott announced the usage of the FreeStyle Libre 14 day system for hospitalized diabetes patients.
- On April 7, Eli Lilly announced a $35 copay for insulin for uninsured and people with commercial health insurance.
For anyone, with or without diabetes, the first thing you should know concerning any flu or virus outbreak is not to panic. At least 32,000,000 people in the United States have had the flu this year and over 18,000 people have died from it. Therefore, be sure to have gotten the flu shot and see your health care provider if you think you might have the flu, so they can test you for it and give you medication to treat it if you have it.
Why it matters for people with diabetes
The current outbreak of coronavirus is a specific respiratory virus first identified in the Wuhan Hubei Province, China. Current symptoms for patients with this strain include mild to severe respiratory illness with fever, cough, and difficulty breathing.
Literature suggests that people with diabetes, especially those with higher blood glucose levels, get infections at a somewhat higher rate than those who do not have diabetes and can often have poorer outcomes, which is why it is important to get recommended vaccinations. Since diabetes is a chronic condition, the heightened concern is understandable. When people with diabetes develop an illness it can be harder to treat because of fluctuations of glucose levels and the presence of other complications. If someone with diabetes becomes ill it is particularly important to go to the doctor to get a diagnosis so it can be treated (for reference, there are 4 different oral medications available for treating the flu). If someone with diabetes is unable to keep down fluids, they should seek medical attention so they can receive intravenous fluids to keep safe.
In general, when someone with diabetes gets sick, management simply becomes harder. Staying hydrated, nourished, and constantly checking BGs is crucial. It’s important to make sure you aren’t in DKA and check for ketones in the event of high BGs.
A few helpful tips
The World Health Organization recommends the following to manage your health proactively and ward off any respiratory system threats:
- Frequently clean hands by using alcohol-based hand rub or soap and water
- Avoid touching surfaces others have touched. Use your knuckles to push buttons, elbows to open doors, disinfectant wipes to clean tables or chairs. Use gloves or wipes to pump gas or when pushing grocery carts.
- Teach yourself not to touch your face. If you must do so, then wash/sanitize hands, touch your face, wash hands/sanitize afterwards.
- Practice social distancing—keep 6 feet away from others in public places
- When coughing and sneezing cover mouth and nose with flexed elbow or tissue – throw tissue away immediately and wash hands
- Avoid close contact with anyone who has a fever and/or cough
- If you have a fever, cough and/or difficulty breathing seek medical care early and share previous travel history with your healthcare provider. Contact your healthcare provider via phone/portal first. Going into clinic can expose you to the virus, so if you are told not to go in then don’t. Many centers have increased their use of telemedicine.
- When visiting live markets in areas currently experiencing cases of novel coronavirus, avoid direct unprotected contact with live animals and surfaces in contact with animals
- The consumption of raw or undercooked animal products should be avoided. Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination with uncooked foods, as per good food safety practices.
The World Health Organization reassures the public that: “Given the current spread of this virus and the pace and complexity of international travel, the number of cases and deaths will likely to continue to climb. We should not panic, even though we are dealing with a serious and novel pathogen.”
Now that the coronavirus has spread to several countries, and there are a growing number of cases in the United States, it is important to stay on top of healthy practices and be aware of potential susceptibility. It is no longer merely travelers from China who pose the possibility of passing the virus on to others, so it’s important to be mindful of your health and the environment you’re in. To keep up with coronavirus updates and resources, follow this page from the CDC.
This issue is not likely to go away until we have a vaccine, which won’t be for a year or two. And it is likely to get worse over the next few months to years. Therefore, learning how not to get infected is important. Human bodies have never been exposed to this specific virus before, so we are particularly susceptible to it. However, it seems LEAST dangerous in children and young people so it is preventing transmission to older people that is most vital. For instance, use of non-contact tools, such as Facetime and Skype is a better way to connect with grandchildren than in-person visits.
Possible medical supply issues
A lot of people are wondering how COVID-19 will affect the production of diabetes supplies and medications, including insulin. The FDA has indicated that they are “closely monitoring the situation,” and as of March 20, there have been no reports of direct impact to any diabetes products.
Our parent organization, Beyond Type 1, reached out to insulin and device manufacturers for comment on potential supply chain issues and received the following responses, which you can read here.
Be sure to renew and refill prescriptions well before you run out. If clinics and pharmacies become busy with sick people, or healthcare employees become ill, it may be harder to get routine care and supplies. A few actions you can take now:
- Contact your physician and make sure all your prescriptions are current and have a maximal number of refills available. Consider back-up medications, like having long-acting insulin on hand if you are a pump user.
- You may be able to refill a prescription even it is before the typical 30-day time window. Call your pharmacy to find out if your state and/or health insurance company has waived refill restrictions because of COVID-19.
- Call your insurance company and find out if you can enroll to receive 90-day prescription refills via mail-order shipments.
America’s Health Insurance Plans (AHIP) has published this list of what individual health insurance providers are doing to support their plan members during the COVID-19 pandemic. Please check the list for information specific to your insurer, or call your insurance company if they are not listed. If you are currently uninsured and need access to supplies, especially insulin, learn more about your options.