Diabetes and the coronavirus: Navigating facts, feelings and COVID-19

Experts say that people with diabetes are "high risk"

The American Diabetes Association notes that individuals who struggle to keep their blood glucose within range the majority of the time are considered immunocompromised, due to the negative effects of elevated blood glucose on the immune system. As someone with diabetes, this means you should be a bit more conscientious of social distancing guidelines and avoid contact with others as much as possible.

Although you're not at a higher risk of contracting COVID-19 than the general population, you are at a higher risk of hospitalization and developing complications due to the coronavirus. Additionally, being ill with a viral infection increases the risk of diabetic ketoacidosis (DKA).

Accordingly, it's a good idea to self-isolate as much as possible, and if you feel you've contracted the virus, seek medical attention immediately. The Centers for Disease Control and Prevention (CDC) lists the following as common symptoms of COVID-19:

Cough

Shortness of breath or difficulty breathing

Fever

Chills

Muscle pain

Sore throat

New loss of taste or smell

In addition to these symptoms, less-common side effects include nausea, vomiting and diarrhea. In the case that mild to moderate symptoms arise, individuals are instructed to care for themselves at home.

Staying in touch with your doctor is important, as they are best positioned to advise you on a treatment plan for diabetes and the coronavirus. If you've contracted a mild case, your physician will ask you to continue monitoring blood glucose levels to avoid hypoglycemia, hyperglycemia and DKA. If your condition worsens or symptoms of DKA manifest, medical attention should be sought as soon as possible.

Managing physical and emotional concerns related to COVID-19

This pandemic has caused many in the diabetes community to wrestle with feelings of vulnerability. Taking care of your type 1 diabetes (T1D) often requires adhering to fine-tuned regimens and striving for a handle on difficult-to-manage situations. The current situation has caused a significant disruption in routines and a loss of feeling in control — so don't feel as if you're alone in this!

Here are several tips for managing the physical and emotional concerns you may have:

Practice good hygiene while avoiding exposure to the virus. Follow CDC guidelines, which include washing hands, maintaining at least six feet of distance from others, covering your nose and mouth with cloth face masks when needing to go out in public and limiting exposure to other people as much as possible.

Leverage diabetes management best practices to maximize time-in-range. As a person with diabetes, the best way to minimize risk of contracting COVID-19 is to increase the health of your immune system, which can be done by keeping your blood glucose levels as close to normal as possible. Even if you're always on top of your levels, it can't hurt to pay a bit more attention these days.

Simplify care. To address concerns about exposure at the pharmacy when picking up insulin and supplies, you may want to look into prescription delivery. Commercial and independent pharmacies offer mail-order or local delivery options, as do many medical supply companies. Telehealth is another emerging option for care at a distance, allowing patients to meet with their doctors and care team from home.

Acknowledge feelings. The news can be particularly distressing for people with diabetes who are concerned about contracting COVID-19. You may have experienced emotions stemming from an overall sense of fear, distress due to language that has been used around high-risk populations during the pandemic and concerns about changes in your ability to access regular care and medications. It's absolutely OK to feel a wide spectrum of emotions — so don't be afraid to acknowledge your feelings! Experiment with strategies for self-care, such as meditation, journaling and gentle movement. Reaching out to a mental health professional during this time may also help.

Prepare for alternative scenarios. A common concern for people living with T1D is the potential for hospitalization, and COVID-19 has definitely heightened this fear. The best strategy for achieving peace of mind is to be prepared. Review diabetes care plans in the event symptoms develop. If possible, keep 30 days worth of insulin and supplies on hand in case you need to self-isolate or there's an interruption in the supply chain. Write back-up plans to let emergency contacts know how they can help support you when you're feeling unwell. Include a list of current medications and other need-to-know personal health information. Finally, prepare a bag of supplies in case of hospitalization.

Give some grace. These are not normal times, so variations in regular exercise routines and certain food choices that help to manage blood glucose are to be expected. Reevaluate how to approach these things and figure out the best way to nourish your body and mind with the time and resources available at the moment. Practice mindfulness to release negative feelings associated with these changes that are outside of your control.

Continue to use your best judgment

There are still many uncertainties around diabetes and the coronavirus. People who live with diabetes are well-positioned to handle what may come, as they are already in the practice of using evidence-based facts combined with their best judgment to overcome health-related challenges on a regular basis. They are resilient out of necessity and know how to hold on to hope in tough times — just like you.

Interested in learning more about improving immunity by increasing your time-in-range? Check out this article for more information about factors that affect blood glucose levels.