COVID-19 Risk Demonstrates Importance of Keeping Diabetes Under Control

March 27, 2020
Gianna Melillo
Gianna Melillo

Gianna is an assistant editor of The American Journal of Managed Care® (AJMC®). She has been working on AJMC® since 2019 and has a BA in philosophy and journalism & professional writing from The College of New Jersey.

According to the CDC, individuals with diabetes may experience more serious complications from the novel coronavirus (COVID-19) than the general population.

As the novel 2019 coronavirus (COVID-19) continues to spread, social distancing remains a vital mitigation practice, ensuring those over age 65 or with serious chronic medical conditions have limited chances of contracting the virus. Diabetes is one of the most prevalent pre-existing conditions in the country, with over 34.2 million Americans, including 14.3 million seniors, living with the disease in 2018.

The CDC has classified individuals with conditions like diabetes as being at higher risk of experiencing complications from COVID-19 than the general population. Citing the International Diabetes Federation, Kenneth Moritsugu, MD, chief medical officer of the American Diabetes Association (ADA), explained what exactly it means to be in a ‘high risk category.’

“Those of us who live with diabetes…are challenged every day. When we become ill, we are really ill-equipped to respond as well as somebody who is healthy, without diabetes. That challenge makes an infection with COVID-19 even more dangerous to our health and well-being,” said Moritsugu in a video published by the ADA.

It is still unknown whether there is a difference in risk among type 1 and type 2 patients. However, age, additional comorbidities, and management of the disease all play important roles when assessing complication risks.

In addition, there is currently not enough data to conclude whether individuals with diabetes are more likely to contract the virus in general.

“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,” the ADA website states.

Along with practicing social distancing, responsible management of diabetes remains imperative. If individuals with diabetes effectively manage their condition, the risk of getting severely sick from COVID-19 is about the same as the general population.

Fluctuating blood sugar, a result of ill-managed diabetes, generally increases the risk 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,” the ADA website reads.

Viral infections can lead to increased inflammation and increased risk of diabetic ketoacidosis (DKA) among people with type 1 diabetes.

Ensuring medications are refilled, washing hands, not touching one’s face, and staying at home are steps individuals with diabetes can take to help mitigate the spread of COVID-19, and aid in effectively managing their diabetes throughout the pandemic.

Keeping sufficient supplies of oral drugs to manage blood sugar, insulin, and any related supplies such as syringes or pens, insulin pump supplies, pen needles, glucose strips, lancets, alcohol swabs, ketone strips, glucagon on hand, will help individuals and caretakers restrict trips to public spaces, according to Diatribe, a diabetes advocacy platform. The website also offers additional information on refilling prescriptions and how insurance companies have responded to the outbreak.

At this time, leading manufacturers report the pandemic has not impacted manufacturing and distribution of insulin. If individuals are struggling to afford insulin, they can visit InsulinHelp.org. The Juvenile Diabetes Research Foundation (JDRF) also lists suppliers’ public statements regarding supply chains on their website.

Healthy family members living in a household with individuals with diabetes should “conduct themselves as if they were a significant risk to [individuals with diabetes],” the ADA notes. This includes washing hands before interacting with family members with diabetes, cleaning all utensils and surfaces regularly, and, if possible, making a protected space for family members with diabetes.

“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,” the ADA advises.

Resources for employees with diabetes concerned about the pandemic can be found here.