The Coronavirus (COVID-19) continues to spread around the world. Dealing with this outbreak is stretching healthcare systems in many countries This could indeed be one of the most serious global health security threats we have witnessed in decades.

Our hearts go out to all who have been affected and we are sincerely grateful to the thousands of healthcare workers around the globe who are on the front lines helping their communities. One of those healthcare providers is our co-founder, Dr. Arna Guðmundsdóttir, endocrinologist, who recently shared the following guidance with her patient group and which we are pleased to share with you:

Diabetes has a debilitating effect on people’s immune system, which causes people living with diabetes to take longer to fight infections and fully recover. It is also possible that the virus will live longer in a high glucose environment. When people with diabetes get a viral infection, it can be more difficult to treat it due to an increase in blood sugar levels. It can also complicate matters if the individual has known diabetes complications e.g. heart disease, renal impairment, hypertension or other. In light of this, people with diabetes are considered at increased risk of severe illness from COVID-19 infections. 

What can be done to mitigate the effects of infections? 

First, it is important to avoid infection by all means and to be even more cautious than others. It is crucial, as it is for everybody to: 

• wash your hands frequently and thoroughly; 
• avoid touching your face before washing and drying your hands; 
• disinfect surfaces that you often touch;
• do not share food, eyeglasses, towels, utensils, etc. with others;
• cough in the elbow patch or in a cloth;
• avoid anyone with symptoms of respiratory tract infection;
• avoid crowded places (travel, concerts, movies, public transport) and finally if you are ill … stay at home!

Second, if you have diabetes you need to take extra measures like:

• Prepare yourself well in case you need to quarantine or be isolated for a period of time. 
• Make sure you have enough supplies of insulin and other antidiabetic medicines. Also have plenty of strips for measuring, blood blades and needles on pens. Try to have enough supplies to last for around 4 weeks. 
• Be careful to have enough to eat, especially the kinds of food you usually use to avoid hypoglycemia. If you have a sudden drop in blood sugar levels, be sure to have glucose tablets, glucose gel and Glucagen hypostop syringes handy. Hypoclycemia could for example happen if you lose appetite due to illness.
• Infections of any kind increase your need for fluid so be sure to drink plenty of water and other fluids.
• Try to measure your blood sugar levels regularly if you become sick and especially if you run high fever. It might be necessary to check your temperature every 2-3 hours and inject extra rapid insulin to keep your blood sugar level in good range. Always inject the base dosage of insulin and keep in mind that sometimes it is necessary to add to the dosage.
• Seek your doctor’s advice regarding the need to adjust the dosage of your diabetes medications (this applies, for example, to jardiance, toxia, glimeryl and metformin)
• If you have Type 1 diabetes, the risk of diabetic ketoacidosis (DKA) increases during acute illness. Be sure to recall the instructions you have received on how to respond during illness. Have urine testing strips available to measure ketones levels in your urine and contact your health care provider if you suspect ketoacidosis.
• If you get flu-like symptoms, like run high fever, cough or have difficulty breathing, it is very important that you contact a doctor. Keep the contact details for your doctor or other healthcare provider handy.
• If you live alone, make sure someone you trust knows that you have diabetes and is ready to help you in case you get sick and need assistance.

Good luck! 

Arna Guðmundsdóttir endocrine physician