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Diabetes & COVID-19

Below is general guidance on COVID-19 as it relates to people with diabetes; however, we advise you consult your doctor for the most current guidance and recommendations on specific aspects of your treatment.The CDC has determined that people with diabetes are at higher risk for getting very sick if they contract COVID-19. The American Diabetes Association has resources available to help you prepare and learn more.

Helpful Links

American Diabetes Association
COVID-19 & Diabetes Flyer (PDF)

​Frequently Asked Questions

If I have diabetes, am I more likely to get COVID-19?

No, it does not appear people with diabetes are more likely to be infected.

If I get COVID-19, will I be sicker than those who do not have diabetes?

People with diabetes do face a higher chance of serious complications from COVID-19. If diabetes is well-managed, the risk of severe illness is similar to that of the general public. If diabetes is not well-managed and blood sugars fluctuate, the risk for diabetes-related complications increases. Having heart disease or other illnesses in addition to diabetes could worsen the effect of COVID-19, like other viral infections, due to your body’s ability to fight off an infection is compromised.

Viral infections can also increase inflammation in people with diabetes. This leads to above-target blood sugars, and could also contribute to complications.

When sick with a viral infection, people with diabetes face an increased risk of DKA (diabetic ketoacidosis), most common in people with type 1 diabetes. DKA can make it difficult to manage fluid intake and electrolyte levels – which is key to managing sepsis. Sepsis and septic shock are two serious complications experienced by those with COVID-19.

What are the symptoms of coronavirus (COVID-19)?

Symptoms include fever, cough, and shortness of breath – similar to what you may feel with influenza or a bad cold. If you feel like you are developing symptoms, call your doctor.
When you call:

  • Have your glucose reading available
  • Have your ketone reading available
  • Keep track of your fluid consumption and report
  • State your symptoms clearly
  • Ask your questions on how to manage your diabetes

Are the risks different for people with type 1 and type 2 diabetes?

No, it does not appear COVID-19 affects people with type 1 and type 2 diabetes differently. Symptoms and risk varies by age, complications and how well diabetes is being managed.

Will COVID-19 impact my access to insulin and other diabetes supplies?

Manufacturers are reporting no impact on current manufacturing and distribution for insulin and supplies at this time, but that is subject to change. If you are struggling to pay for insulin or know someone who is, the American Diabetes Association has resources to help at InsulinHelp.org.

If I have diabetes, what should I do when feeling sick?

  • Keep taking your diabetes medications or insulin as prescribed. These medications may need to be adjusted to keep your glucose or blood sugar on target.

  • Drink extra water and other calorie-free beverages (i.e. unsweet tea, diet lemonade, sugar-free soda) when sick. If having trouble keeping water down, drink small sips every 15 minutes. Keep hydrated.

  • Try to follow your meal plan. If not eating well, eat small portions of “comfort foods” every 1-2 hours such as a small bowl of soup, ½ cup custard or pudding, 5 vanilla wafers, ½ cup of applesauce or ice cream, ½ cup of juice, or ½ cup hot cereal. Liquid or soft food may be easier to keep down.

  • Track blood glucose more often. Check every 4 hours and keep a log. Write time, date and blood glucose results. There are many tracking apps available to use with smartphones (i.e. Glucose Buddy, MyFitnessPal, BlueStar Diabetes). If you do not have a glucose meter or a continuous glucose sensor, consider buying an over-the-counter meter at your local pharmacy. If you are unable to check your blood glucose level, ask someone to help.

  • Check for ketones in your urine if you are sick with blood glucose over 240 mg/dl more than 2x in a row. Keto sticks are found at drug stores if not already in your sick-day box. If trace or small ketones (turns a little pink or light pink on the strip after urine placed on it) keep drinking water and checking your blood glucose every few hours until ketones are negative or gone in the urine.

If I feel sick, but do not have COVID-19 symptoms, when should I call the doctor?

Call your doctor if you or a loved one:

  • Are spilling medium to large ketones in your urine (the strip will change from beige to brighter pink or purple after placing urine on the strip), or if instructed to do so, call if having trace or small ketones as part of your sick-day plan.
  • Need medication adjustment for fluctuating blood glucose.
  • Are vomiting more than once or have diarrhea 5 or more times within 24 hours.
  • Have a fever over 101 degrees F for more than 24 hours.
  • Are unable to eat or keep fluids down.
  • Have an infection in the feet or legs.
  • Feel exhausted for a long period.
  • Are feeling confused or not thinking clearly.

If I have to go to the ER or hospital, what should I bring?

  • Bring ALL diabetes supplies such as glucose meter, strips, continuous glucose monitor, insulin pump with extra supplies in case you need to be admitted to the hospital.
  • If in the hospital, be involved in your diabetes care by letting the nursing staff know if your blood glucose is fluctuating using the direction arrows on your continuous glucose meter, by your finger stick readings or if having symptoms of high or low blood glucose.
  • Medication needs will change while in the hospital. Some may be increased, reduced, eliminated, or brand changed. You may be prescribed insulin for the first time while in the hospital to assist in your blood glucose control. This is all part of getting well.

What can I expect when I arrive for my visit? What is the visitor policy?

To practice social distancing, clinics are assessing all visits to determine if appointments may be safely delayed and rescheduled. If your appointment is delayed, a member of your care team will contact you to discuss diabetes management, answer questions and reschedule the visit. Where possible, virtual care visits (telehealth) will be used to connect you with your care team from the safety of your own home. While screening policies and procedures are subject to change as new information evolves, you will be screened upon entry to the building/hospital for your visit. View OU Medicine’s most recent visitor policy here.

Questions? Contact the diabetes educators at the Harold Hamm Diabetes Center by calling (405) 271-1000. During this time of social distancing, a virtual visit can be scheduled for sick-day management or other diabetes topics.

*Disclaimer: The COVID-19 pandemic is an evolving challenge. The data and recommendations are changing rapidly as healthcare professionals attempt to best care for both unaffected and affected patients. For more information, please visit oumedicine.com/covid.*