Even in a pandemic of unknowns, it is known that people who have diabetes face greater risks if they contract the virus that causes COVID-19.
“Patients with diabetes mellitus may be at risk of suffering more severe complications, prolonged hospitalizations, greater mortality, and increased recovery time after they’re discharged from the hospital,” explains Gwendolyne Anyanate Jack, MD, MPH, assistant professor of medicine, Weill Cornell Medical College.
Researchers are still evaluating data to quantify the risk and are looking closely at how age, obesity, and other conditions may factor into the picture, Dr. Jack adds. In the meantime, patients with diabetes can take a number of precautions.
Following the guidelines from the Centers for Disease Control and Prevention (CDC), patients are advised to:
“We’re urging patients to follow up regularly with either their endocrinology team or primary care physician,” Dr. Jack says. Physicians can help adjust diabetes medications.
She adds that telemedicine has been a unique opportunity for many practices to offer provide care for patients--without patients leaving home.
Doctors advise their patients to monitor their glucose levels regularly as recommended by their endocrinologist. If possible, patients can send their glucose logs or use a cloud-based platform to share glucose data with clinicians in advance of a telemedicine appointment. For in-person visits, patients are advised to bring their glucose monitoring devices and/or glucose data to all visits, so that they can review them with their physician.
The CDC also encourages patients with diabetes to keep at least a 30-day supply of diabetes medicines, including insulin, on hand.
“But if insurance allows it, a 90-day supply is even better,” Dr. Jack says. “It is important for all patients with diabetes mellitus to have the right medications.”
“We need to emphasize that patients need to work with their medical teams to optimize glycemic control,” Dr. Jack says. She adds: “That means following up regularly to ensure they are on the right doses of the right medications, and following a tailored nutritional and exercise plan. A team-based approach that includes an endocrinologist, certified diabetes care, an education specialist, diabetes nurse practitioner, and collaboration with an internist or other specialists is important for improving diabetes outcomes.”
“Having both flu and the virus that causes COVID-19 could have disastrous results,” Dr. Jack explains. “We overall encourage and advise patients to get the flu vaccine so they have as much protection as possible.”
Viral infections, including COVID-19, can increase blood sugar levels, Dr. Jack says. It could even lead to diabetic ketoacidosis, which requires prompt medical attention. Patients with diabetes mellitus—especially those who are insulin-dependent—should develop a “sick day plan” with their endocrinology team.