Just over 1 in 10 Americans have diabetes and about 1 in 3 have prediabetes, according to a 2020 National Diabetes Statistics Report.

In type 1 diabetes, the body does not produce insulin and in type 2 diabetes, the body is unable to use insulin properly. Insulin is the hormone needed to extract glucose, or blood sugar, from the bloodstream into the cells of the body to use for energy. As a result, blood glucose levels rise higher than normal.

During a COVID-19 infection, blood glucose levels can be particularly difficult to control, and in turn, high blood sugars can interfere with the body’s ability to fight the infection. Viral infections like COVID-19 can also increase inflammation in people with diabetes and make it more difficult to recover.

While there is not enough data to show if people with diabetes are more likely to contract COVID-19 than the general population, those with diabetes who get the virus are at increased risk for complications, especially if blood sugars are not under good control.

According to the Centers for Disease Control and Prevention (CDC), there is ample evidence that people with type 2 diabetes (the most common type) are at increased risk for severe illness from the virus that causes COVID-19. Based upon what we know at this time, people with type 1 diabetes and gestational diabetes may also be at higher risk for more severe illness.

In addition, having other health conditions, such as obesity or heart disease, along with the diabetes, can put one at an even greater risk of getting seriously ill from COVID-19. Older people are also at higher risk of complications if they get the virus.

What should you do if you have diabetes and you develop COVID-19?

When sick with any viral infection, and especially COVID-19, people with diabetes face an increased risk of dehydration and uncontrolled blood sugars. It’s very important to drink plenty of fluids. If it’s difficult, have small sips every 15 minutes or so throughout the day to avoid dehydration. Make sure you have at least a 30-day supply of medications, including insulin.

Also, call your doctor for instructions on how to monitor your blood sugars and adjust for changes as you recover. Check your blood sugar extra times throughout the day and night, including first thing in the morning and two hours after eating. If you note a rising trend, let your doctor know.  

Rising blood sugars may be due to hormones that are released by the body to help the body fight illness. As the blood sugars rise, this increases the amount of medication or insulin that you will need to control your blood sugars. Insulin is particularly important for type 1 diabetics since they need insulin to live. If the body doesn’t have enough insulin it starts breaking down fat as fuel, which produces ketones. When too many ketones are produced too fast, they can cause diabetic ketoacidosis.

Follow these steps if you feel that you are sick, even if blood sugars are in target range:

• Continue taking medications for diabetes.
• Test your blood sugars every four hours and make note of them.
• Drink extra non-caloric beverages.
• Weigh yourself every day, losing weight may be a sign of rising blood sugars.
• Check your temperature every morning and evening.

In addition, if you experience any of the following emergency warning signs, get medical attention immediately:

• Difficulty breathing or shortness of breath
• Persistent pain or pressure in the chest
• New confusion
• Inability to wake or stay awake
• Bluish lips or face

If you have diabetes, what can you do to protect yourself?

No matter what type of diabetes you have, those with existing diabetes-related health problems are likely to have worse outcomes if they contract the coronavirus than people with diabetes who are otherwise healthy. You can lower your risk of getting very ill from COVID-19 if your diabetes is well-controlled.

Taking the standard precautions to avoid infection are essential, as well as controlling your blood sugar through diet, exercise, monitoring and medication. Here are some tips for diabetics during the COVID-19 pandemic:

1. Get the COVID-19 vaccine. Having diabetes places you at an increased risk for complications if you contract COVID-19. The vaccine can help prevent severe illness from COVID-19.
2. Manage your diabetes wisely. Take your medications as directed to keep your blood sugars under control. Stay in close communication with your doctor if you feel ill or have any concerns.
3. Wash your hands often and wear a mask in public.
4. Practice physical distancing. Stay at least 6 feet away from others outside of your household. Avoid large gatherings of people. Consider using mail-order prescription services and grocery delivery services.
5. Be prepared if you do get sick. Keep a supply of fever-reducing medications, like acetaminophen (Tylenol) in your home.
6. Have up-to-date supplies of your diabetic devices and prescriptions (at least a 30-day supply). Stock up on insulin supplies, glucose testing supplies, ketone test strips, glucose tablets and up-to-date prescriptions.
7. Eat healthy. Stock up on foods that are good sources of protein, frozen vegetables as well as non-perishable forms of healthy foods, such as whole grain pastas, brown rice and protein sources.
8. Exercise. Being active makes your body more sensitive to insulin, which can help you better manage your diabetes.

For updates on our planning and response efforts as we work to stop the spread of COVID-19, please check EEHealth.org/coronavirus.

Are you wondering whether to get the vaccine? Read our blog to learn more.

Edward-Elmhurst Health offers screening options for COVID-19. Eleanor, your personal virtual assistant, can help you check your symptoms 24/7 and advise you on what to do next. We also offer Video Visits and E-Visits for COVID-19 symptoms.

The information in this article may change at any time due to the changing landscape of this pandemic. Read the latest on COVID-19.