Coronavirus: specific advice for people with diabetes

Web Resource Last Updated: 10-11-2020

Contents

Having diabetes does NOT mean you are more likely to catch Coronavirus.  However, if you do catch Coronaviruses, it can cause more severe symptoms and complications in people with diabetes. More severe symptoms are also likely in older people, and those with other long-term conditions such as cancer or chronic lung disease.

Latest Updates

New National restrictions in place from 5th of November

COVID-19 case numbers are rising rapidly across the whole of the UK and in other countries so the UK Government is implementing new national restrictions to control the spread of the virus. 

When we reduce our day-to-day contact with other people, we will reduce the spread of the infection. So from Thursday 5 November until Wednesday 2 December, the Government is taking the following action:

  1. Requiring people to stay at home, except for specific purposes.
  2. Preventing gathering with people you do not live with, except for specific purposes.
  3. Closing certain businesses and venues.

Information on the new national restrictions, including what they mean for working from home and business closures, why they are being introduced and the financial support available can be found on the UK Government website

*Please note this national restriction is applicable to England, please see the guidance for Wales, Scotland and Northern Ireland*

Social Bubbles

As part of the new restrictions, from the 5th of November, you must not meet people socially. However, you can exercise or meet in a public, outdoor space with people you live with, your support bubble (or as part of a childcare bubble), or with one other person. You should minimise time spent outside your home. When around other people, stay 2 metres apart from anyone not in your household - meaning the people you live with - or your support bubble. Where this is not possible, stay 1 metre apart with extra precautions (e.g. wearing a face covering).

You must not meet socially indoors with family or friends unless they are part of your household or support bubble.

A support bubble is where a household with one adult joins with another household. Households in that support bubble can still visit each other, stay overnight in each other’s households, and visit outdoor public places together.

Please check the UK Government website for further information on the new national restrictions.

Travel

If you need to travel to work or make an essential journey, you should try to cycle or walk if you can. The gov.uk set out further advice on how to stay safe during your journey

You should wear a mask if you have to use public transport to travel and stay 2 metres apart from people you do not live with where possible, or 1 metre with extra precautions in place.

If you are travelling abroad please follow the latest government guidance.

Wearing a face covering

Face coverings are mandatory in all indoor settings and public transport. Under the new rules, people who do not wear a face-covering will face a fine of up to £100. Children under 11 and those with certain disabilities will be exempt.

The liability for wearing face-covering lies with the individual. To see the UK Government advice about face coverings please click here.

What should I do if I have symptoms?

Do not leave home if you or someone you live with has any of the following: A high temperature, a new, continuous cough, a loss of, or change to, your sense of smell or taste.

Most people with coronavirus have at least one of these symptoms.

Phone your GP if your symptoms:

  • are severe or you have shortness of breath
  • worsen during home isolation
  • have not improved after 7 days

If your GP is closed, use the NHS 111 online coronavirus service or phone NHS 24 (111). In addition, it is now recommended that all individuals living in the same household as an asymptomatic person should self-isolate for 14 days (household isolation). Information on COVID-19, including “stay at home” advice for people who are self-isolating and their households, can be found on the NHS website

If you have diabetes and start to feel unwell you need to follow the sick day rules for type 1 or type 2 and check your blood glucose frequently.

You can find help on HM GOV website if you’re struggling because of coronavirus, for example with paying bills, being out of work or taking care of your mental health. You can also sign up to get emails when they change any coronavirus information on the GOV.UK websites

How coronavirus can affect people with diabetes

Everybody that has diabetes, no matter whether type 1, type 2 or gestational, is at risk of developing a severe illness if they get coronavirus, but the way it can affect you varies from person to person.

When you are ill and have diabetes, your blood glucose levels can be unstable as your body is trying to fight the illness. Your body starts releasing stored glucose into your bloodstream to give you energy. As a person with diabetes, your body either cannot produce insulin or the insulin you produce doesn't work as well. This causes your blood glucose levels to rise further. There is a risk of both high and low blood glucose levels as your body is working overtime to fight the illness.

For most people, the coronavirus causes a mild illness, but some people can develop a more serious form of the virus which can be life-threatening.

SGLT2i medication

If you have type 2 diabetes and you take SGLT2i tablets (medication that ends in 'flozin'), your doctor may want you to stop taking these for just now. This is because SGLT2i tablets can mask the symptoms of DKA (diabetic ketoacidosis) which can be caused by coronavirus.

If you have type 2 diabetes and take SGLT2i tablets, you can keep taking these unless you become unwell. If you are unwell, these tablets could increase your risk of developing diabetic ketoacidosis. 

There are lots of different types of SGLT2i tablets so have a look at Diabetes UK for the full list of brand names.

Shielding advice

Due to the latest rise in infections, everybody - including those that are clinically extremely vulnerable - is required to follow the new National restrictions from 5th of November. These include:

  • people to stay at home, except for specific purposes
  • prevent people from gathering with those they do not live with, except for specific purposes
  • close certain businesses and venues

The UK Government are advising clinically extremely vulnerable people to stay at home as much as possible, except to go outdoors for exercise or to attend essential health appointments. 

Try to keep all contact with others to a minimum and avoid busy areas. Whenever you go out, continue to maintain strict social distancing, wash your hands regularly and avoid touching your face. You should also try to stay 2 metres away from other people within your household, especially if they display symptoms of the virus or have been advised to self-isolate.

The UK Government website has further information on the new national restrictions and what that means for people that are classed as clinically vulnerable.

Other TIPS to keep safe and well 

If you have type 1 diabetes:

  • Ensure you have enough glucose and ketone testing equipment
  • Be aware of you sick day rules provided by your diabetes educator team
  • Make sure you have a good stock of insulin pens, needles and any other medications you are prescribed
  • Stay hydrated – have plenty of unsweetened drinks and eat little and often
  • If you are an insulin pump user you should have insulin pens as a backup and a good supply of insulin pump consumables
  • Make sure your diabetes technical device  (insulin pump /continuous glucose monitor/Freestyle Libre device is in good working order and if you have any concerns phone the company who supplies your device directly to troubleshoot and arrange a replacement if necessary.

If you have type 2 diabetes:

  • Ensure you have enough glucose testing equipment and if appropriate ketone testing strips (this might be if you have had your diabetes for a long time or have had ketones in the past). Ketones are uncommon in type 2 but remain a risk if glucose is high for a significant time &/or during illness.
  •  Make sure you have a good stock of your medications, orals tablets &/or injectable therapies.
  •  Be aware of you sick day rules provided by your diabetes educator team
  • Stay hydrated – have plenty of unsweetened drinks and eat little and often

For the most up-to-date advice then keep checking the UK government and NHS websites.

Additional JDRF advice for Type 1 diabetes can be found here.

To avoid catching or spreading Coronavirus:

Do:

  • Wash your hands with soap and water frequently – wash for at least 20 seconds
  • Always wash your hands when you get home or into work
  • Use hand sanitiser gel if soap and water isn’t available
  • Cover your mouth and nose with a tissue when you cough or sneeze
  • Put used tissues in the bin straight away and wash your hands
  • Try to avoid close contact with people that are unwell
  • Maintain social distancing according to government guidelines on what you can and can’t do
  • Read more about staying safe outside your home on GOV.UK.
  • Cover your face by wearing a face mask over your nose and mouth in enclosed spaces

Don't

  • Touch your eyes, nose or mouth if your hands are not clean
  • Do not use pocket-handkerchiefs as these are unhygienic, instead use single-use tissues.

If you have hospital and GP appointments

Do not go to the GP surgery, pharmacy or hospital if you have coronavirus symptoms. If you are having treatment for something such as an eye or foot problem and you do not have coronavirus symptoms, then your appointments should still carry on unless you have been contacted to cancel it. If you are in any doubt then phone the number on your appointment letter.

Most routine appointments such as your annual diabetes review have been delayed or postponed for just now. These will be rescheduled once the situation returns to normal. In the meantime keep up your routine of checking your feet, keeping to a healthy diet and doing some physical activity.

If you notice something different that you are concerned about such as a cut or blister to your foot, call your GP and let them know. If you cannot get through then call 111 for advice. If you have a change in your vision you should get in touch with your local screening service or optometrist. 

Children and school

Schools, colleges and universities remain open even with the new national restrictions that are in place from the 5th of November. 

Everyone, including children, can get coronavirus. All of the guidance regarding social distancing and washing applies to children with diabetes too. Schools should be practising social distancing for your child when they're at school. This is to prevent the virus from spreading between children and your home.

You may be worried about the safety of your child going to school if they have diabetes. Speak to the school and to your child’s diabetes team about your concerns. Read Diabetes UK guide for parents on what you should expect from your child's school – including doing a risk assessment and having the right policies in place.

You can find all of the latest news from the government about coronavirus on their website.

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