This information is based on current knowledge of COVID-19 and will be updated as additional scientific evidence is released.
We know you have questions. We have answers.
There is not enough data to show whether people with diabetes are more likely to get COVID-19 than the general population. The problem people with diabetes face is primarily a problem of worse outcomes, not greater chance of contracting the virus. In China, where most cases have occurred so far, people with diabetes had much higher rates of serious complications and death than people without diabetes—and generally we believe that the more health conditions someone has (for example, diabetes and heart disease), the higher their chance of getting serious complications from COVID-19. While the death toll is likely to rise as the virus spreads, we expect the death rate—the number of people who die from the virus as a percentage of the total number of people who contract the virus—to go down as we get better at detecting and treating this specific virus.
People with diabetes do face a higher chance of experiencing serious complications from COVID-19. In general, people with diabetes are more likely to experience severe symptoms and complications when infected with a virus.
Your risk of getting very sick from COVID-19 is likely to be lower if your diabetes is well-managed. When people with diabetes do not manage their diabetes well and experience fluctuating blood sugars, they are generally at risk for a number of diabetes-related complications. Having heart disease or other complications in addition to diabetes could worsen the chance of getting seriously ill from COVID-19, like other viral infections, because your body’s ability to fight off an infection is compromised.
Viral infections can also increase inflammation, or internal swelling, in people with diabetes. This is also caused by above-target blood sugars, and both could contribute to more severe complications.
When sick with a viral infection, people with diabetes do face an increased risk of DKA (diabetic ketoacidosis), commonly experienced by people with type 1 diabetes.
DKA can make it challenging to manage your fluid intake and electrolyte levels—which is important in managing sepsis. Sepsis and septic shock are some of the more serious complications that some people with COVID-19 have experienced.
If your blood sugar has registered high (greater than 240 mg/dl) more than 2 times in a row, check for ketones to avoid DKA.
COVID-19 is proving to be a more serious illness than seasonal flu in everyone, including people with diabetes. All of the standard precautions to avoid infection that have been widely reported are even more important when dealing with this virus.
Recommended safety precautions are the same as for flu, such as frequent hand washing and covering coughs and sneezes with a tissue or your elbow.
We encourage people with diabetes to follow the guidance of the CDC and to review how you manage sick days—preparing for a sick day can make it easier.
Pay attention for potential COVID-19 symptoms including fever, dry cough, shortness of breath, chills, repeating shaking with chills, muscle pain, headache, sore throat, and new loss of taste or smell. 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 (you can use a 1-liter water bottle) and report
- Be clear on your symptoms (for example: are you nauseated? Just a stuffy nose?)
- Ask your questions on how to manage your diabetes
If you develop emergency warning signs for COVID-19 get medical attention immediately. In adults, emergency warning signs include:
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest
- New confusion or inability to arouse
- Bluish lips or face
In general, we don’t know of any reason to think COVID-19 will pose a difference in risk between type 1 and type 2 diabetes. More important is that people with either type of diabetes vary in their age, complications and how well they have been managing their diabetes.
People who already have diabetes-related health problems are likely to have worse outcomes if they contract COVID-19 than people with diabetes who are otherwise healthy, whichever type of diabetes they have.
For people with underlying health conditions, including diabetes, healthy family members in the household should conduct themselves as if they were a significant risk to them. For example, they should be sure to wash their hands before feeding or caring for them. If possible, a protected space should be made available for vulnerable household members, and all utensils and surfaces should be cleaned regularly.
If a member of your household is sick, be sure to give them their own room, if possible, and keep the door closed. Have only one family member care for them, and consider providing additional protections or more intensive care for household members over 65 years old or with underlying health conditions. Learn more about how to keep your home safe here.
Leading manufacturers are reporting that COVID-19 is not having an impact on their current manufacturing and distribution capabilities for insulin and other supplies at this time. We are continuing to monitor the situation and will provide updates should anything change. If you are struggling to pay for insulin or know someone who is, the ADA has resources to help—visit InsulinHelp.org.
Yes, for more information, please visit https://www.diabetes.org/coronavirus-covid-19/know-your-rights-covid-19.
Yes. The FDA recognizes that home-use blood glucose meters may be an option to provide relief and support to health care professionals in hospital settings seeking to reduce interactions between patients and health care providers, thereby limiting exposure to COVID-19, and conserving personal protective equipment (PPE), whenever possible.
In addition, some home-use blood glucose meters have built-in wireless data transmission capabilities, which can facilitate remote patient monitoring. Therefore, the FDA encourages hospitals to consider policies to allow patients to self-test using home-use blood glucose meters, which may include leveraging patients’ own home-use blood glucose meters or dispensing a home-use blood glucose meter upon in-patient admission to the hospital. Utilization of strategies in which hospitalized patients may conduct their own blood glucose testing, while allowing wireless access to results by health care professionals, may limit the number of necessary patient contacts, thereby reducing risk of viral transmission and preserving a hospital’s limited supply of PPE.
In considering whether to allow in-patients to self-test using home-use blood glucose meters, health care providers caring for COVID-19 patients can take into consideration the availability of other equipment in their hospitals to get timely and accurate blood glucose readings that can be easily transferred or logged into the patient’s medical record. Health care providers can also take into consideration whether the patient is well enough or sufficiently lucid to properly conduct their own self testing and whether the patient is comfortable with using an unfamiliar home-use blood glucose meter, if one was dispensed by the hospital. While a patient may be used to getting blood glucose readings using their own meter, the patient may not be as successful using an unfamiliar model.
In the case of home-use blood glucose meters, health care professionals in hospitals may choose to have patients utilize home-use meters to monitor blood glucose levels of patients when they have already been hospitalized due to COVID-19. In addition, self-testing by patients, even while in the hospital, is already within the authorized FDA-labeling for home-use meters.
Yes. Self-management of diabetes by a patient using their own devices, even in a hospital setting, is consistent with device labeling.
No. All blood glucose meters labeled “for single patient use only,” whether dispensed by the hospital to a patient or brought in to a hospital by a patient, may only be used by the individual patient. Blood glucose meters labeled “for single patient use only” may not be shared among multiple patients. This limitation is necessary to prevent transmission of infection between individuals as these types of glucose meters are not adequately robust to withstand the cleaning and disinfection that would be necessary to enable multiple patient use. Any home-use blood glucose meter dispensed to an admitted patient should either be taken home by that patient or disposed of upon the patient’s discharge from the hospital.
No, people should not consume or misuse disinfectants. According to the CDC, household cleaners and disinfectants can cause health problems when not used properly. Follow the instructions on the product label to ensure safe and effective use.
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If COVID-19 is spreading in your community, take extra measures to put distance between yourself and other people to further reduce your risk of being exposed to this new virus. Stay home as much as possible.