The recent Coronavirus (COVID-19) outbreak, which started in China and has been spreading across the globe, has taken the media by storm. Many have raised concerns about the inevitability of a pandemic, with many news articles addressing the issue and related concerns in recent months. Here, we provide a brief overview of COVID-19 pathogenesis and answer some common questions about how to protect yourself and what steps to take if you believe you are experiencing symptoms of the infection as a person with diabetes.
Fast Facts
- The virus is thought to be mainly spread from person to person through respiratory droplets from coughing and sneezing, and may also live on various surfaces, that if touched, could result in infection
- Those infected may have no symptoms at all or may exhibit varying degrees of fever, coughing, and shortness of breath
- The best ways to protect yourself and help prevent the spread of the virus include common-sense measures, like minimizing the risk of potential exposure (e.g., limiting travel, especially to affected areas; not touching your face), and maintaining cleanliness (e.g., washing your hands)
Your Questions Answered
We recently took to social media to gain insight into common concerns and questions about Coronavirus as it relates specifically to people living with diabetes. Here, we answer some of the common questions we received:
Why are people with diabetes more vulnerable to infections and complications of infections?
It has been shown that people with diabetes are at a higher risk for infections and related complications, and, in particular, for various bacterial infections. Although the reasons for this are not completely elucidated yet and are likely multifactorial, research has shown that high blood glucose levels can directly and negatively impact the immune system and that
“…good control of blood sugar in diabetic patients is a desirable goal in the prevention of certain infections and to ensure maintenance of normal host defense mechanisms that determine resistance and response to infection.”
As it relates to the COVID-19 outbreak, it follows that maintaining optimal blood glucose control is an important preventative strategy for avoiding serious related complications, such as a secondary bacterial infection (i.e., pneumonia) and is likely an important determinant in the patient prognosis for anyone who becomes infected.
How might blood sugar be affected if I get the virus?
In general, many types of illness can cause an increase in blood glucose levels (even in people without diabetes) that may necessitate medication adjustments in order to maintain control. This is often true for other viral infections, like influenza. While it is difficult to predict individual responses, as blood glucose levels are governed by a combination of many factors, it is likely that infected individuals may experience higher than expected blood sugar levels.
What can I do to protect myself?
In addition to the importance of maintaining optimal glycemic control as a person with diabetes (see above), the best ways to protect yourself include the same common-sense measures that are advocated by the CDC.
Elizabeth Gomez, MSN, FNP-BC explains:
“Precautions to prevent Coronavirus are hand hygiene and keeping distance from people who are sick or who have recently traveled to known areas identified by the CDC as having outbreaks (i.e., China, North Korea, Japan, Italy).”
What should I do if I have symptoms?
Much like for the general population, it is recommended that people with diabetes who are experiencing symptoms of COVID-19 infection take steps to get the appropriate testing and medical care, while also helping to contain spread of the disease. People with diabetes are advised to call their healthcare provider for advice promptly. It is not recommended to go to the emergency room to seek hospitalization, unless there is another emergency situation suspected, such as ketoacidosis (DKA).
Elizabeth Gomez, MSN, FNP-BC says:
“It is important they get evaluated if the history is suggestive of Corona in order to track the disease and report to the Department of Public Health. They should be evaluated by a provider if they have a positive history of travel to the affected areas and they have symptoms of fever, cough, shortness of breath or other respiratory symptoms.
Treatment is similar to supportive care but if people have comorbidities (like diabetes) they should follow up closely with the treating provider to prevent complications. The mortality rate is low, so it is expected people will recover well.”
Can the disease be transmitted via injections or fingerpricks?
The CDC explains that COVID-19 appears to predominantly spread via respiratory droplets, but also may live on various hard surfaces. However, the virus is new, and the spread of the virus is not fully understood yet. Some concerns have been raised about other potential routes of transmission (e.g., blood).
In any case, it is good practice, in general, to never share insulin pens, syringes, or lancing devices and to always change your own syringe or pen needle when injecting insulin, as well as to change your lancet each time you check your blood sugar level.
Conclusions
In general, patients with diabetes are currently advised to follow the same guidelines as the general population when it comes to protecting themselves from the Coronavirus outbreak. Taking care to avoid exposure, as well as common-sense prevention, like washing your hands and not touching your face as much as possible, are key. Be sure to consult your healthcare provider for additional guidance on your specific situation in order to stay safe.
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