Q&A: COVID-19 and Diabetes

People with diabetes have specific concerns about the new coronavirus (COVID-19). We answer some of your most pressing questions.

Are people with diabetes more likely to get COVID-19?

There’s no evidence that people with underlying conditions such as diabetes are more likely to contract COVID-19.

Are people with diabetes more likely to have severe symptoms if they get COVID-19?

People with diabetes have a higher chance of developing serious complications from the disease, including pneumonia, sepsis, respiratory failure, acute kidney injury, and death.

In a report published on March 31, 2020, in Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention (CDC) reviewed data on Americans who were confirmed to have COVID-19 between February 12 and March 28 of this year. Among 457 people who were admitted to the intensive care unit (ICU), 78 percent had one or more underlying conditions, such as diabetes and cardiovascular disease. Among the more than 1,000 hospitalized patients, 71 percent had one or more underlying conditions, compared with only 27 percent of the COVID-19 patients who weren’t hospitalized.

In another study, published in the journal Diabetes Metabolism Research and Reviews on March 31, 2020, Chinese adults with diabetes (but without other conditions) were more likely to have serious health issues from COVID-19, including severe pneumonia and excessive inflammation.

Why are people with diabetes more likely to have serious complications from COVID-19?

First, the good news: If your blood glucose is well managed, your risk for serious complications from COVID-19 is the same as people without diabetes.

However, blood glucose that’s not in your target range does raise your chance of getting very sick from the virus, just as it would if you were sick with the yearly flu.

Plus, people with diabetes are more likely to have related conditions, such as kidney disease and heart disease, both of which are risk factors for severe illness with COVID-19. These complications make it more difficult for the body to fight off viral infections such as COVID-19.

Illness, including viral infections such as COVID-19, can increase the risk for diabetic ketoacidosis (DKA), a serious complication in which the body produces too many ketones. DKA is a dangerous complication on its own, but it can also increase the likelihood of sepsis, a life-threatening complication experienced by some people with COVID-19. Ask your doctor if you should be checking for ketones.

Learn the symptoms of and how to monitor for DKA.

Finally, viral infections can also increase inflammation in people with diabetes, leading to more-severe complications of COVID-19.

Does COVID-19 affect people with type 1 and type 2 diabetes differently?

There’s no reason to think so at this time. People whose blood glucose isn’t within target range, who have existing diabetes-related health problems, or who are age 65 or older are more likely to develop complications from COVID-19, whether they have type 1 or type 2.

How can family members protect loved ones with diabetes or other underlying conditions?

If you or someone you live with has diabetes, everybody in the household needs to take extra precautions. Everyone should wash their hands frequently, especially if they’re caring for someone with an underlying health condition such as diabetes.

Should a family member develop symptoms of COVID-19, he or she can protect the rest of the household by staying in a separate room with the door closed at all times.

For more information, visit the American Diabetes Association and the Centers for Disease Control and Prevention.

Sources: American Diabetes Association; Centers for Disease Control and Prevention

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