What can you do?

Take these precautions and encourage your community to join you. The recommendations have been endorsed by members* of The American Diabetes Association, Beyond Type 1, Harvard Medical School, ISPAD, and JDRF and are being shared by diabetes communities around the world to keep the most vulnerable among us safe. 

Join the movement – boost the signal. Organizations interested in becoming a sharing partner e-mail: coronavirus@beyondtype1.org

 

RECOMMENDATIONS FOR PEOPLE WITH DIABETES

The following recommendations clarify how to best protect yourself and others from contracting COVID-19. They are not exhaustive, but every action taken counts. Overall, act as though you may have COVID-19 and could pass it on – asymptomatic spread has been shown to be a driver of this global pandemic. 

 

Approved vaccines protect against severe symptoms, hospitalization and death from COVID-19 while slowing the spread to others – get the vaccine as soon as you are able.

• People with diabetes have been included in clinical trials of approved vaccines with no consistent or major side effects reported.
• All vaccines can impact blood sugar levels for the first 24 to 48 hours after receiving them. Check blood sugar levels frequently, stay hydrated, and be familiar with your sick day routine. The mild symptoms you may experience after the vaccine are significantly safer and more easily managed than potentially getting COVID-19 itself.
• Advocate for equitable distribution and access to the COVID-19 vaccines in your local and global communities.

Elevated average blood sugar levels in individuals with diabetes is a risk factor for more severe COVID-19 outcomes – set yourself up for success with diabetes management.

• Test blood sugar levels more often; your body may be reacting differently under these new circumstances. Maintain a routine of physical movement and blood sugar friendly eating. 
• Contact your doctor or health professionals by phone/telehealth if possible for personal diabetes management advice, especially if your blood glucose numbers are consistently out of range.
• Familiarize yourself with how to check for ketones. If you have adequate supplies, check for ketones regularly regardless of blood sugar levels.
• Secure a sufficient amount of your standard management supplies as well as supplies to check ketones and treat severe hypoglycemia (glucagon).
• Lean on your community for help – none of these behaviors are easy, and we all need support. Look into diabetes online communities.

Being overweight/obese and smoking are also major risk factors for more severe COVID-19 outcomes – maximize baseline physical and mental health to improve physical immunity.

• If you smoke or vape, stop now. 
• Prepare meals at home using whole foods and stay hydrated. 
• Be sure to exercise, in your home or in an outdoor area where you can easily maintain distance from others.
• Get a sufficient amount of quality sleep – most adults need 7+ hours per night, children need more (at least 9). 
• Reach out to others to stay in touch virtually, especially those who may need help.
• Check in with your mental health, including substance use and other potentially harmful habits. If you are struggling with mental health, seek online help.

Many are returning to work and school – make environments as safe as possible.

• Work from home as much as you can. Look into modifications in work procedures to keep 2 meters / 6 feet distance from others. Adjust your schedule to avoid high-traffic times. 
• Know your rights. Health organizations including the CDC list diabetes as a high-risk condition amidst COVID-19. Diabetes is a protected disability in many countries, including the US. Reasonable accommodations are lawfully required.
• If you manage a work or school environment, ensure precautions are being set up for vulnerable individuals. Advocate for flexible work options for high-risk individuals.

Early detection of COVID-19 or other health issues can be life saving – if you get sick, get treated quickly. 

• Never stop taking insulin or other medications, even when you become sick. Discuss insulin, metformin, or other medication dosage changes with a doctor.
• Make sure you have a diabetes-specific sick day management plan ready, just in case. 
• Know the warning signs of diabetic ketoacidosis (DKA) and seek immediate medical attention for symptoms including fruity smelling breath, vomiting, weight loss, dehydration, confusion, and hyperventilation.

Basic precautions save lives – continue strict personal hygiene habits.

• Wear a mask in indoor public spaces and avoid prolonged exposure to aerosolized particles – e.g. indoor spaces with low ventilation, especially featuring loud conversation or singing.
• Wash hands every time you come into contact with an out-of-home item or place.
• Regularly disinfect high-touch surfaces in your home, cough or sneeze into your elbow or a tissue, and avoid touching your face.

If you have diabetes and contract the novel coronavirus, contact your healthcare professional immediately. For more information, visit this resource from the Diabetes Disaster Response Coalition. 

* Thank you to Professor Kim C Donaghue, President of ISPAD 2018-2020, Paediatric Endocrinologist, Sydney Children’s Hospitals Network, Discipline of Child and Adolescent Health, University of Sydney (chair); Dr Anju Virmani, Senior Consultant Pediatric Endocrinologist, Max, Pentamed & Rainbow Hospitals, Delhi, India.; Dr Carine de Beaufort, MD, PhD, President of ISPAD 2021, Guest professor, Département de Pédiatrie UZ-VUB, Brussels, Belgium, DECCP, Clinique Pédiatrique/CH de Luxembourg; Dr Luis Eduardo Calliari, MD. ISPAD Communication Director, Member of Brazilian Diabetes Society Executive Board, Professor at Santa Casa School of Medical Sciences, São Paulo, Brazil; Dr. Rachel Swift, Chief of Strategy Global, JDRF; and others.

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