What You Should Know About COVID-19

The year 2020 has certainly thrown all of us a curve ball! Since the introduction of COVID-19, from directions to shelter-in-place, wear masks in public, and remain socially distant from others, to local toilet paper shortages, we’ve experienced more than most of us could have ever imagined!

While much of what’s happening with the COVID-19 pandemic is unprecedented, the fundamentals of diabetes self-management still ring true. Finding ways to be active, eating healthfully, and working towards achieving diabetes goals is arguably more important than ever. While having diabetes alone is not known to put a person at higher risk for contracting COVID-19, people with diabetes are at higher risk in general for having less optimal outcomes if they become infected¹. On a positive note, having well managed diabetes is likely to lower the risk of severe illness^1,2,3.

Here’s what you should know about COVID-19.

Signs & Symptoms:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

The list above was last updated by the Centers for Disease Control and Prevention (CDC)⁴ on May 13, 2020 and may continue to change as the medical and scientific community works to study the disease. Click here to review the most up-to-date information from the CDC.

Strategies to Decrease Risk of Contracting a COVID-19 Infection:

• Follow the recommendations of the CDC for how to stay healthy.
• Follow the recommendations of your healthcare team, particularly in the event they have more strict recommendations than the CDC. They know your complete medical history, including what other diagnoses you may have and the medications you take. These are important considerations when looking at an individual person’s risk.

What Can You Do NOW to Minimize the Severity of Illness Should You Contract COVID-19?

• Continue routine diabetes care and don’t skip appointments.
  • If you’re uncomfortable with in-person visits, check with your healthcare team to see if virtual appointments may be an option.
• Try to maintain an active lifestyle and healthy diet.
• Optimize glucose levels by looking at your trends in CareLink software.
  • Upload data to CareLink weekly or every other week to help you and your healthcare team assess how you’re doing.
  • If you’re unable to upload to CareLink, people on the MiniMed 630G or MiniMed 670G system can view your Time in Range on your pump.
• Seek guidance from your healthcare professional if you experience unexpected changes to your glucose or if your Time in Range is less than 70% (or the individualized goal Time in Range your healthcare professional has recommended for you). This may be a sign you need to make some changes to your diabetes management.
• Ensure you maintain a supply of all your diabetes essentials, including ketone strips (unexpired!), insulin, blood glucose test strips, reservoirs, infusion sets, batteries, quick-acting carbohydrates to treat lows, and anything else you may need.

It’s more challenging to manage diabetes during illness because the body releases hormones in response to an infection or illness⁵. Some hormones promote the release of glucose into the blood stream, and others change the way your body responds to insulin. While every person and situation can be different, most times people become more insulin resistant when the body is fighting an infection. This means you may require more insulin than you would expect during an illness. In addition to high blood sugar levels that may result from the stress of illness, some medications may also contribute to high blood sugars. The most common are steroids, which may be used to treat diseases, including COVID-19⁶. Therefore, close communication with your diabetes healthcare team is important during illness and when new medications are added to your plan to ensure your glucose levels and insulin doses are assessed and modified appropriately.

Keep in mind, the topics and suggestions in this blog do not take the place of medical advice or guidance. Be sure to remain in communication with your healthcare team if you have questions or concerns about your diabetes management or the way COVID-19 is impacting you personally.

Let’s continue to forge through the global pandemic and find new ways to thrive together!

References:
¹American Diabetes Association (n.d.) . How COVID-19 impacts people with diabetes . Retrieved August 5, 2020, from https://www.diabetes.org/coronavirus-covid-19/how-coronavirus-impacts-people-with-diabetes

²Ho, C., Ng, N.B.H., Lee, Y.S. (2020). Caring for pediatric patients with diabetes amidst the Coronavirus disease 2019 storm. The Journal of Pediatrics, 1097-6833.

³Erener, S. (2020). Diabetes, infection risk, and COVID-19. Molecular Metabolism, pp. 101044; doi: 10.1016/j.molmet.2020.101044

⁴Centers for Disease Control (2020). Coronavirus Disease 2019 (COVID-19). Retrieved 7/19/2020 from https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

⁵Kitabchi, A.E., Miles, J., Umpierrez, G.E., & Fisher, J.N. (2009). Hyperglycemic crisis in adult patients with diabetes. Diabetes Care, 32, 1335-1343. doi: 10.2337/dc09-9032

⁶Wicaksana, A.G., Hertanti, N.S., Ferdiana, A., & Pramono, R.B. (2020). Diabetes management specific considerations for patients during coronavirus disease pandemic: A scoping review. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14, 1109-1120. https://doi.org/10.1016/j.dsx.2020.06.070

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