Coronavirus (COVID-19) – advice for people living with diabetes (UK)

From diabetes.org.uk

Updated 10th March - A number of you have been in touch looking for advice relating to the global Coronavirus (also known as COVID-19) outbreak. We have developed this detailed advice on coronavirus for people living with diabetes with NHS England and NHS Improvement, and Public Health England.

Specific advice on coronavirus for people living with diabetes

Coronaviruses can cause more severe symptoms and complications in people with diabetes, as well as in older people, and those with other long term conditions such as cancer or chronic lung disease.
If you have diabetes and you have symptoms such as a cough, high temperature and feeling short of breath, you need to continue taking your medication and call the NHS 111 phone service. For those who routinely monitor their blood glucose, on the advice of their clinical team, they should continue to do this more often.

If you have diabetes and have been travelling abroad, and you think you may have been exposed to Coronavirus, follow the most up-to-date advice on what to do which can be found on the NHS or government websites.

If you have diabetes and you become unwell for any reason, it’s important that you follow ‘sick day rules’.

Sick day rules

• Contact your GP, Practice Nurse or Diabetes team, who will help you if you have any queries or if you are unsure about what to do.
• Follow the advice of your GP, Practice Nurse or Diabetes team regarding your medication if you feel unwell.
• If you routinely check your blood sugar at home you'll probably need to do it more often. This will depend on your normal medications and how you use insulin.
• If you don't test your blood sugar levels at home, be aware of the signs of a hyper (hyperglycaemia); which include passing more urine than normal, especially at night; being very thirsty; headaches; tiredness and lethargy. If you have hyper symptoms contact your GP.
• Stay hydrated – have plenty of unsweetened drinks and eat little and often.
• If you have type 1 diabetes, check your blood sugar at least every four hours, including during the night, and check your ketones if your blood sugar level is high (generally 15mmol/l or more, or 13mmol/l if you use an insulin pump, but your team may have given you different targets). If ketones are present, contact your diabetes team.
• Keep eating or drinking – if you can’t keep food down, try snacks or drinks with carbohydrates in to give you energy. Try to sip sugary drinks (such as fruit juice or non-diet cola or lemonade) or suck on glucose tablets or sweets like jelly beans. Letting fizzy drinks go flat may help keep them down. If you're vomiting, or not able to keep fluids down, get medical help as soon as possible.

Attending routine appointments

People with diabetes should continue to attend their routine appointments as normal – unless they hear otherwise from their local GP practice, hospital or diabetes team.

Coronavirus Q&A

People living with diabetes

Question 1: Do I need to do anything differently to the general public living without diabetes in regard to coronavirus?
We recommend everyone follows the NHS advice around reducing the risk of picking up infections including thoroughly washing your hands frequently, practicing good hygiene and avoiding contact with people who are unwell.  
Coronaviruses can cause more severe symptoms and complications in people with diabetes, as well as in older people, and those with other long term conditions such as cancer or chronic lung disease.
If you are worried you might have been in contact with someone with confirmed coronavirus, call 111 (England, Wales and Scotland) or 0300 200 7885 (Northern Ireland). 

Question 2: The NHS website says the symptoms and complications of coronavirus can be worse in people with diabetes. Would I be more likely to die? 
Coronaviruses can cause more severe symptoms and complications in people with diabetes, as well as in older people, and those with other long term conditions such as cancer or chronic lung disease. The risk of death from coronavirus is quite low, and the majority of people with coronavirus will have a comparatively mild illness.
It is important that people with diabetes follow the sick day rules should they become ill from any illness. If you routinely check your blood sugar at home, you'll probably need to do it more often – at least every four hours, including during the night.

Question 3: What will happen to my diabetes appointments? Will they be postponed? Should I still go to hospital and GP appointments?
The NHS will continue to provide diabetes appointments as normal, therefore people with diabetes should continue to attend appointments as normal. In the event of any disruption you will be informed ahead of your appointment by your local GP practice or hospital.

Question 4: What are the symptoms likely to be?
The NHS outlines the common symptoms of coronavirus on its website. These symptoms are the same for people living with diabetes. Coronavirus can have serious effects on anyone who has a long term health condition or a weakened immune system. Follow advice on avoiding catching or spreading germs as above.
Get advice straight away if you are in contact with someone with confirmed coronavirus, or if you need medical help.

Question 5: What should I do if my clinician is diagnosed with coronavirus?
If your clinician is diagnosed with coronavirus and you have not seen them recently, then you are unlikely to have been exposed to coronavirus. The risk associated with any healthcare workers who become infected with coronavirus is assessed on a case by case basis and appropriate action taken. You should follow the advice given to you if you are contacted because you have been exposed to coronavirus in this way.

Question 6: Should I go to work / not see friends / not see friends who’ve travelled from affected areas?
We recommend everyone follows the NHS and government advice around reducing the risk of picking up infections, including following the latest guidance on avoiding crowded places if this becomes necessary, or coming into contact with the condition.
We recommend everyone follows the NHS and government advice about what to do if they are concerned they have come into contact with someone with the coronavirus.
The Foreign Office has the most up-to-date information about how different countries are affected.

Question 7: What if I have travel planned or a holiday booked to one of the affected areas – am I more at risk if I do travel?
The Foreign Office has the most up-to-date information about how different countries are affected.

Family, friends or carers of people living with diabetes

Question 8: I have been exposed to the virus and am a carer for someone with diabetes. What should I do?
We recommend everyone follows the NHS advice around reducing the risk of picking up infections including thoroughly washing your hands frequently, practicing good hygiene and avoiding contact with people who are unwell.
If you have been in close contact with someone with confirmed coronavirus, call 111 (England, Scotland and Wales) or 0300 200 7885 (Northern Ireland).
If you are advised by 111 staff or other medical professionals to self-isolate then this would include minimising close contact with others. 

Question 9: I am a carer to someone with diabetes. Should I be doing anything differently?
We recommend everyone follows the NHS advice on reducing the risk of picking up infections including thoroughly washing your hands frequently, practicing good hygiene and avoiding contact with people who are unwell.

The future

Question 10: If the pressure on the NHS grows, will my appointments be delayed, or will I have problems accessing my medication?
The NHS is continuing to provide diabetes appointments as normal. In the event of any disruption, clinicians will always make decisions to prioritise treatment for those most in need and in consultation with patients. Local health systems will also put in place contingency arrangements to best support patients. The NHS has conducted extensive work on supply chains to ensure a secure supply of necessary drugs.

The government action plan, issued on 3 March, says that if transmission of the virus becomes established in the UK population, the nature and scale of the response will change: “The chief focus will be to provide essential services, helping those most at risk to access the right treatment. This means that treatment and the requirement for medicines and other clinical countermeasures might start to increase, with the need to draw down on existing stockpiles of the most important medicines, medical devices and clinical consumables.”

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