The day-to-day regimen of managing and living with diabetes can be overwhelming. Managing diabetes during an illness can make it even more difficult.
With the global pandemic of the novel coronavirus (COVID-19), there is a great need to focus on preventing the disease and diabetes-related complications.
The COVID-19 outbreak was declared a global pandemic by the World Health Organization. The disease is primarily spread through large respiratory droplets and is affecting many countries worldwide.
People living with diabetes are at an increased for various infections, such as influenza and pneumonia. It is not necessarily known at this time if people with diabetes have an increased risk of COVID-19. However, it is believed that people with diabetes may be at a higher risk due to their underlying medical condition, especially if not well controlled.
Having coexisting heart disease, kidney disease and advanced age are also likely to further increase the severity of COVID-19.
We can suspect that better blood sugar control may help prevent contracting the virus. Additionally, maintaining blood sugar control may lead to milder cases and better outcomes if one does contract COVID-19.
People with diabetes should take these general measures to prevent COVID-19:
1. Handwashing with soap and water, use alcohol-based hand rubs, practice proper respiratory hygiene and practice social distancing.
2. Avoid touching highly-touched surfaces in public places — like elevators buttons, door handles, handrails, etc.
3. Clean and disinfect your home, especially frequently touched items like doorknobs, light fixtures, faucets, phones, etc.
4. Maintain blood sugar control.
Thoroughly washing your hands with soap and water will help kill the virus. The use of alcohol based (at least 60% alcohol) hand rub is useful as well.
It is important to remember to cover your mouth and nose with the bend of your elbow or with a tissue when coughing or sneezing. Also, avoid touching your mouth, nose and eyes.
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Make sure to take care of yourself:
For most people with diabetes, it is recommended to have a fasting blood sugar from 80-130 and blood sugar less than 180 after meals. It is important to check your blood sugar often.
Please, remember to have adequate nutrition and hydration. Exercise has been shown to help immunity and to decrease stress. Try to include some form of physical activity as tolerated in your daily schedule.
If you have diabetes and develop fever, cough, runny nose or shortness of breath, please notify your health care provider.
If you become sick:
1. Test your blood sugar frequently (at least every four hours)
2. Check your temperature every morning and evening
3. Weigh yourself daily
4. Keep a log of your blood sugar, temperature and weight
5. Drink fluids to keep hydrated
If you experience vomiting and/or diarrhea and are unable to eat and keep down fluids, this may lead to hypoglycemia (low blood sugar) and can cause issues with management. Also, it is important to check your blood sugar and urinary ketones in case of fever and hyperglycemia (elevated blood sugar).
Please notify your health care provider of any extreme hypoglycemia or hyperglycemia, as your medications may need to be adjusted. Do not delay seeking emergency care for your diabetes.
Preparation is important:
Do not wait until your last vial or pen of insulin to get your medications refilled. Make sure you have enough inulin, medications and supplies (testing strips, glucagon, etc.) for at least a month. Ask your health care provider for a 90-day supply and possible mail order to limit contact and reduce trips to the pharmacy.
Stock up on nonperishable items during this time. Remember to have fast acting carbohydrates, such as juice, sport drinks and regular sodas for possible episodes of low blood sugar.
It has been a very trying and emotional time for everyone during this pandemic. Your mental health is just as important as your physical health. You may feel as if the world has turned upside down.
If you are feeling more anxious or overwhelmed, talk with your health care provider for possible resources.
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I would also encourage you to take this time to enjoy your family by cooking a healthy meal together. You can also take long walks together as a family or exercise together in the privacy of your home.
If you have experienced financial hardships due to COVID-19, some pharmaceutical companies are offering assistance with insulin and other medications during this time.
Your health care team is here to help you manage your diabetes. Do not panic, but please be prepared.
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