In recent weeks, there has been a lot of focus on how coronavirus affects people with diabetes. NHS research  has found that diabetes significantly increases a coronavirus sufferer’s risk of dying, and that people with type 1 diabetes are more likely to die of Covid-19 than those with type 2 diabetes.
The data from NHS England showed that of the 22,332 people who died in hospital between the dates of 31st March and 12th May, 5,873 were previously diagnosed with either Type 1 or Type 2 diabetes. That means 25% of people who passed away in hospital due to coronavirus had diabetes.
It is important to note that having diabetes does not mean you are more likely to catch coronavirus. However, if you do catch coronavirus, diabetes can cause more severe symptoms and complications.
Jon Cohen, Emeritus Professor of Infectious Diseases at Brighton and Sussex Medical School, said: “Diabetic patients are probably not at greater risk of catching coronavirus, but do have a greater risk of becoming seriously ill if they do catch it.”
Here’s your complete guide to coronavirus and diabetes.
How coronavirus can affect people with diabetes
If you have diabetes, you can become seriously ill with coronavirus if you catch it, although how it affects an individual varies from person to person.
If you have type 1 or type 2 diabetes, you are particularly vulnerable to becoming seriously ill with Covid-19 because the virus can cause difficulties managing your diabetes, potentially leading to DKA (diabetic ketoacidosis).
Contracting an illness when you have diabetes can lead to unstable blood sugar levels. Your body tries to fight the illness by releasing stores sugar into your bloodstream to give you energy. However, your body either cannot produce insulin, or the insulin you produce doesn’t work as well as it should, so your blood sugar levels rise.
Most people who contract coronavirus experience a mild illness. However, some people develop a more serious form of the disease and this can lead to illness or even death.
So, if you have diabetes, it is important that you take care to social distance and avoid catching the virus. It’s also important for you to seek medical advice if you do become ill.
A quick note about SGLT2i medication
If you have type 1 diabetes and you take SGLT2i tablets (this is any medication that ends in 'flozin'), your doctor may want you to temporarily stop taking these. This is because SGLT2i tablets can mask the symptoms of DKA which can be caused by coronavirus.
If you have type 2 diabetes and take SGLT2i tablets, you are able to keep taking these unless you become unwell. If you are unwell, these tablets could increase your risk of developing DKA.
What should I do if I have diabetes and I have coronavirus symptoms?
The main symptoms of coronavirus are:
- A new continuous cough – coughing for more than an hour, or three coughing fits in a 24-hour period
- A high temperature – you feel hot to touch on your back or chest or your temperature is above 37.5 degrees celsius
- Loss or change to your sense of smell or taste – either things taste different to normal or you cannot smell or taste anything
If you develop any of these symptoms, even if they are mild, you should stay at home for seven days from the onset of symptoms. Don’t go to your GP surgery, a pharmacy or the hospital if you think you have coronavirus. However, you should telephone your GP if these symptoms:
- Worsen during the period you are self-isolating
- Are severe or if you have shortness of breath
- Have not improved after seven days
If you cannot speak to your GP surgery, use the NHS 111 online coronavirus service or telephone NHS 24 (111).
The guidance also states that any individuals living in the same household should self-isolate for 14 days.
If you have diabetes and start to feel unwell you need to follow the sick day rules for:
- Type 1 on multiple daily injections
- Type 1 on an insulin pump
- Type 2 and check your blood glucose frequently.
Coronavirus and Diabetes Shielding Advice
If you are extremely vulnerable and at a very high risk of severe illness from coronavirus, you may be ‘shielding’.
This involves staying at home and avoiding face-to-face contact with everyone for a period of at least 12 weeks. Those that are classed as extremely vulnerable are people with certain types of cancer and severe respiratory conditions. You can find out more about shielding and who should be following this advice on the UK government website .
If you have diabetes you may need to follow this shielding advice if you have other medical conditions - for example, those with kidney disease or cystic fibrosis-related diabetes.
However, under the current advice, most people with diabetes do not need to shield. However, you should still avoid social contact and stay at home as much as possible. If you have not had any instructions from the NHS to shield, you should follow the ‘stay at home’ guidance.
It is important that you keep up to date with the current guidance in case the advice changes.
Following the NHS study into the risk of coronavirus to people with diabetes, Professor Peter Horby , chair of the New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) advisory group, said diabetes was being considered as part of an "active review" of the most vulnerable groups.
If you are in type 2 diabetes remission
Diabetes remission works differently for different people, and so there is no way of knowing how coronavirus could affect you if you are in remission.
So, if you are in diabetes remission, you should also follow the ‘stay at home’ guidance.
Tips for keeping safe during Coronavirus
Here are some more tips to help to keep you well.
If you have type 1 diabetes:
- Make sure you are aware of the sick day rules. There is some good advice online
- Make sure you have enough glucose and ketone testing equipment
- Make sure you have a good stock of insulin pens, needles and any other medication you have been prescribed
- Make sure your diabetes technical device (for example, an insulin pump, continuous glucose monitor or Freestyle Libre device) is in good working order. If you have any concerns, telephone the company who supplies your device directly to troubleshoot and arrange a replacement if necessary
- Stay hydrated – make sure you have plenty of unsweetened drinks and eat little and often.
If you are an insulin pump user, you should also have insulin pens and pen needles as a backup and a good supply of insulin pump consumables.
If you have type 2 diabetes:
- Make sure you are aware of the sick day rules – there is advice on the NHS website
- Ensure you have enough glucose testing equipment and ketone testing strips if appropriate (if you have had diabetes for a long time or have had ketones in the past).
- Make sure you have a good stock of your medications, tablets and/or injectable therapies
- Stay hydrated – have plenty of unsweetened drinks and eat little and often
If you have diabetes, you may believe that you won’t be able to take out life insurance. Or, perhaps you have been turned down for cover in the past?
The good news is that there are many insurers who will consider your diabetes life insurance application even if you have diabetes. They will need plenty of information from you – when you were diagnosed, what medication you are taking etc. – but it is possible to give your family the peace of mind that there is financial support in place if the worst should happen.
We’re specialists in helping people with diabetes to get the life insurance they need.
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