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Coronavirus and Diabetes: 5 Things You Should Know

Checking glucose with a monitor

It’s scary. It’s lurking around. And it can be deadly.

The Coronavirus (officially known as the COVID-19) presents unique challenges to people living with high blood sugar, whether you have diabetes or prediabetes.

Why? Because “sweet people” (those with high sugar) are more susceptible to catching viruses when exposed to them because our immune system defenses are weakened just from the fact of having high sugar. And we’re more likely to have a more severe response to catching a virus than those who don’t have diabetes or prediabetes.

Sadly, people are dying from this virus at much higher rates than those who die from the flu, even though reports suggest our risk is still relatively low for the COVID-19. We hear about those dying have underlying disease or health issues, or are older… but healthy people have died too.

So, let’s breakdown 5 things you should know to better protect yourself.

  1. Assume rates in the U.S. are way higher than reported, so act accordingly.
    Several news stories reported the testing kits to detect COVID-19 weren’t readily available in the U.S. and some of the ones that went out were defective. My personal belief is that the rates will mushroom in the coming days and weeks if more kits become available and we accurately report those results.Take Italy for example. They had widespread use of the kits to detect the virus and reported their results. Much more to learn from Italy as I have first-hand reporting from several friends who live there and are witness to the complete mayhem that’s unfolded, elements which are bound to repeat here as the level of reported cases rise.
  2. Don’t pass the virus to yourself or others.
    Viral particles can live on hard surfaces (like metal, think doorhandles, rails, grocery carts, etc.) for at least a few hours, but by far the most common way it’s spread it person-to-person via air when someone coughs or sneezes. Yeah, yeah, “Wash your hands and don’t touch your face with unwashed hands” but have you given thought to your nails and your rings? They can harbor lots of microbes (namely bacteria and viruses). So when you hear authorities talk about the time it takes to wash your hands effectively, it’s 20 seconds – are you actually scrubbing that long? Many studies show most don’t, including healthcare workers. Yikes! But also, did you know the proper technique to washing hands includes lathering and scrubbing your hands not under running water? Yep. Get your hands wet, then the soap, then scrub without water, then rinse under running water, aaaaaaaaand dry thoroughly. If your hands are damp, you’re at risk to picking up microbes that comes your way. Hand sanitizers are also effective, so use them when you’re out and about. A nice visual from the CDC exemplifies the steps needed:
    Be kind and stay at home if you’re sick. And when you do cough, do so into your elbow or a tissue (then throw the tissue away).
  3. Know the symptoms of the coronavirus (COVID-19).
    According to the CDC, the following symptoms may appear 2-14 days after exposure: fever, cough and shortness of breath. But according to Todd Ellerin, a Harvard infectious doctor, some people have the infection and don’t have symptoms. Others have a low-grade fever, body aches, nasal congestion, a runny nose, or a sore throat. Other reports on social media say it first manifest with a sore throat and dry cough. Everyone is different. So, if you start to not feel well, stay hydrated and rope your healthcare provider in if your condition changes for the worse. Be sure to read through to #5 about specifics actions to take that could save your life.
  4. Have a plan to survive on quarantine for at least 2 weeks.
    This may sound dramatic and exaggerated but that’s what’s happening now in Italy. It’s been described as wartime. Streets are empty, grocery store shelves are empty, and massive amounts of business are closed. As of this blog publication date, the entire school system in Italy is closed. That includes universities and libraries, and even cherished museums. Sports events are cancelled. And some Emergency Rooms have closed because they cannot keep up with the demand and have to divert people elsewhere. Imagine a stroll in Rome where you see no one. And the isolated person who does show up, ducks out of sight the moment they’ve make eye contact. Everyone thinks everyone is a potential carrier because you can have no symptoms and still pass on the virus. Many are working from home if they’re lucky enough their type of business offers that, and many others are on home quarantine.This personally inspired me to take a look at my earthquake kit. I live in California and we’re all “supposed to” have earthquake kits – something set aside that would sustain you in the event of a loss of power and water for a 72 hours but preferably a week. After listening to UCSF’s Matt Springer’s talk about preparing for an earthquake many years ago, I finally put together a kit. Then I promptly forgot about it. Uh oh. When I just checked on my astronaut food in my kit, it had expired back in 2012. I was good about keeping enough water on hand but after hearing the horrors of what’s happening in my beloved Italia, it was a stark reminder of the importance of being prepared. Time to update!We all need to have a disaster-preparedness kit. When you have diabetes, this means making sure you have enough supplies, especially medication that will last at least a week. You can find some checklists from the Association of Diabetes Care and Education Specialists (formerly known as the American Association of Diabetes Educators). It certainly requires more planning than just depending on the cans of food laying around in your cabinets! So make it a weekend or evening project to take care of this week.
  5. Know what your blood sugar is doing and have a plan for when you get sick!
    Let me share a story that I’ve seen happen too often. It’s a story that you can personally avoid and it all starts with monitoring blood sugars during times of illness. I used to work in ICU. A gentleman came in unconscious with a blood sugar of over 1,800. What.. the.. heck? How can that happen? Who even knew the blood sugar could go that high? Well, he was the bread winner for his family. He caught a bug and felt under the weather. Like many of us, he went to work. It continued for another day, then another and another, so he muscled through it. He felt sick, was coughing, wasn’t hungry, so he wasn’t eating – AND WARNING: HERE IS THE TRAP YOU CAN AVOID – so he thought since he wasn’t eating, his blood sugar should go down and since he wasn’t eating, he didn’t take his diabetes medications. Big red flag!!! When you’re sick – whatever the cause – blood sugars tend to go up. Even when you’re not eating. You may actually need more medication when your body is trying to battle the flu. And the only way to know is to check your sugar. Had he done so, he would have had the feedback that his numbers were climbing rapidly. He was becoming severely dehydrated. He had type 2 diabetes and got into a very dangerous situation called Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS). It can be deadly and he was so lucky to live to tell his story.

    Check your glucose at least a couple times a day when you’re sick

And I’ve seen others in his situation including a woman who also wasn’t checking her sugars because she was sick. I mean, when you’re on the couch sick as a dog, the last thing you want to do is jab your finger and get a blood sugar result, but that can save your life. She also had HHNS with a blood sugar crossing 2,000 which was too much for her body to handle. This “worse-case scenario” situation will hopefully save you from putting your meter in the drawer when you’re sick. It’s critical to know what your blood sugar is doing because then you can get help when it goes to high – which by the way, you want to have clear direction from your provider as to when you should call. What blood sugar is too high? Typically, if you are sick and your blood sugar is above 240 mg/dL, you need to call or take action however advised.

Finally, be sure you have enough on hand to deal with being sick. Do you have anti-fever medication? Foods that are easy to take? Like even when you’re sick, you need energy, so if you can only tolerate a sip of something, that’s the time to have a regular soda on hand, like mamma used to give us 7-Up when we were sick. Do you have broth? Saltine or gluten-free crackers if that’s what you’d normal eat? Apple sauce? The kinds of comfort foods that will help you get some carbs into your system is what you need to have on hand. The ADA put together a list of considerations. It’s worth a read to see what applies to you.

Lastly, several immunizations are recommended for people with diabetes. That includes getting the flu shot although that won’t protect you from the COVID-19.

I hope this gives you some ideas on how to stay safe given the unfolding virus outbreak, no matter your blood sugar. Stay well and stay sweet.

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2 Comments on “Coronavirus and Diabetes: 5 Things You Should Know

Brenda Balducci
March 6, 2020 at 8:38 pm

Thank you, for your concise and much needed explanation, specifically meant for those of us with diabetes. You’re the best 👍

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Theresa Garnero
March 9, 2020 at 7:53 pm

So glad this is useful, Brenda! Great to hear from you. 🙂

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