What Should I Do If I Have Symptoms of COVID-19?

As the global viral outbreak continues, you may be wondering what special considerations there are for people with diabetes to keep in mind. In particular, what should you do if you begin to experience symptoms consistent with the infection? This article reviews the most common COVID-19 symptoms, discusses potential issues specific to people with diabetes, and provides a guideline of how to respond if you become sick.

Symptoms of COVID-19

Be on the lookout for the following most common symptoms of COVID-19:

  • Fever
  • Coughing (especially dry)
  • Shortness of breath

Other symptoms may include fatigue, body aches, and sore throat, among others.

Special Considerations for People with Diabetes

You may have heard that people with certain medical conditions, including those with diabetes, are considered to be in the high-risk group for developing more serious symptoms of the disease, and have been reported to have a significantly higher mortality rate than those without underlying conditions. While these statistics are both relevant and can be scary, it is also important to keep in mind that your individual risk will vary widely depending on your specific health status, regardless of your diabetes diagnosis. Your age, other related and unrelated health conditions, and blood glucose management profile, all play a role in determining your overall risk. So, while as a whole population, people with diabetes are at higher risk for complications, your individual risk could be much lower than that.

For instance, as per the JDRF, those who have type 1 diabetes are  “not necessarily at higher risk of developing serious complications from the disease. Those at greatest risk are those who have another, or second chronic disease (such as a compromised immune system, heart disease or renal failure).

Talk to your healthcare provider to better understand your individual risk level and recommendations.

Have a Plan of Action If Symptoms Arise

Being adequately prepared ahead of time can help you feel calmer and more empowered if you do get sick. Consider taking the following steps today, if you haven’t already:

  • Take preventative measures. Stay home. Practice social distancing (note: if you already have symptoms, self-isolate!)
  • Wash your hands. Avoid touching your face. Disinfect “high-touch” surfaces regularly.
  • Make sure that your medication refills are up-to-date so that you have the supply you need if you will stay in your home for a long period of time (e.g., at least several weeks). Make sure that you consider supplies used for diabetes management as well as any other medications that you use.
  • Check that you have medications on hand that you would typically use to treat a viral infection, such as a fever-reducing agent, like acetaminophen (Tylenol). Consult with your healthcare provider for advice about their specific recommendations.
  • Have enough food and water in your home in case you stay home for a prolonged period of time (e.g., several weeks).
  • Review the “Sick Day Rules” for people with diabetes. COVID-19 causes mild symptoms in most of the people who are infected. This means most likely, you will be treating your symptoms at home. However, any illness can make blood glucose levels more challenging to manage. It is important to be aware of how illness can affect your management plan and make adjustments as needed, with the help of your healthcare provider, to keep yourself safe during the illness. You can find the standard “Sick Day Rules” as described by the Joslin Diabetes Center here, but discuss your specific recommendations with your healthcare provider.

So, what should you actually do (and not do) if you develop symptoms of COVID-19?

  1. Don’t panic.
  2. Self-isolate. Don’t go to urgent care or the emergency room, unless instructed to do so or you experience serious symptoms (see below). Stay home.
  3. Call your doctor and follow their advice closely.
  4. Keep a close eye on blood sugar levels. Work with your healthcare provider to make adjustments to medications, if needed, to help stay in the target glycemic range as much as possible. Keeping blood glucose levels in check as much as possible can go a long way to helping you avoid complications during any illness.
  5. Manage your specific symptoms (e.g., fever). Ask your healthcare provider for specific at-home treatment advice.
  6. Stay hydrated. This can help you keep your blood sugar levels in the target range and avoid complications.
  7. Be on the lookout for serious symptoms, including those of diabetic ketoacidosis (DKA), as well as the following “COVID-19 emergency warning signs”:
  • Difficulty breathing
  • Chest pain
  • Confusion or difficulty waking
  • Blue tint to the skin (on the lips or face, in particular)

If you experience these any of these symptoms, promptly seek medical care. Wear a mask if out in public.

  1. Continue to wash your hands and clean surfaces regularly.
  2. Continue to avoid contact with others (humans and pets).
  3. Do not discontinue isolation until you get the “all clear” from your healthcare provider.

***

For even more detailed information on what to do if you are ill, read these guidelines from the CDC:

What to Do if You’re Sick

Guidelines for At-Risk Populations

Also, learn even more about COVID-19 illness with diabetes from the American Diabetes Association (ADA) here.

Source: diabetesdaily.com

Coronavirus & Diabetes: Your Questions Answered

The recent Coronavirus (COVID-19) outbreak, which started in China and has been spreading across the globe, has taken the media by storm. Many have raised concerns about the inevitability of a pandemic, with many news articles addressing the issue and related concerns in recent months. Here, we provide a brief overview of COVID-19 pathogenesis and answer some common questions about how to protect yourself and what steps to take if you believe you are experiencing symptoms of the infection as a person with diabetes.

Fast Facts

  • The virus is thought to be mainly spread from person to person through respiratory droplets from coughing and sneezing, and may also live on various surfaces, that if touched, could result in infection
  • Those infected may have no symptoms at all or may exhibit varying degrees of fever, coughing, and shortness of breath
  • The best ways to protect yourself and help prevent the spread of the virus include common-sense measures, like minimizing the risk of potential exposure (e.g., limiting travel, especially to affected areas; not touching your face), and maintaining cleanliness (e.g., washing your hands)

Your Questions Answered

We recently took to social media to gain insight into common concerns and questions about Coronavirus as it relates specifically to people living with diabetes. Here, we answer some of the common questions we received:

Why are people with diabetes more vulnerable to infections and complications of infections? 

It has been shown that people with diabetes are at a higher risk for infections and related complications, and, in particular, for various bacterial infections. Although the reasons for this are not completely elucidated yet and are likely multifactorial, research has shown that high blood glucose levels can directly and negatively impact the immune system and that  

“…good control of blood sugar in diabetic patients is a desirable goal in the prevention of certain infections and to ensure maintenance of normal host defense mechanisms that determine resistance and response to infection.”

As it relates to the COVID-19 outbreak, it follows that maintaining optimal blood glucose control is an important preventative strategy for avoiding serious related complications, such as a secondary bacterial infection (i.e., pneumonia) and is likely an important determinant in the patient prognosis for anyone who becomes infected.

How might blood sugar be affected if I get the virus? 

In general, many types of illness can cause an increase in blood glucose levels (even in people without diabetes) that may necessitate medication adjustments in order to maintain control. This is often true for other viral infections, like influenza. While it is difficult to predict individual responses, as blood glucose levels are governed by a combination of many factors, it is likely that infected individuals may experience higher than expected blood sugar levels.

What can I do to protect myself? 

In addition to the importance of maintaining optimal glycemic control as a person with diabetes (see above), the best ways to protect yourself include the same common-sense measures that are advocated by the CDC.

Elizabeth Gomez, MSN, FNP-BC explains:

“Precautions to prevent Coronavirus are hand hygiene and keeping distance from people who are sick or who have recently traveled to known areas identified by the CDC as having outbreaks (i.e., China, North Korea, Japan, Italy).”

What should I do if I have symptoms?

Much like for the general population, it is recommended that people with diabetes who are experiencing symptoms of COVID-19 infection take steps to get the appropriate testing and medical care, while also helping to contain spread of the disease. People with diabetes are advised to call their healthcare provider for advice promptly. It is not recommended to go to the emergency room to seek hospitalization, unless there is another emergency situation suspected, such as ketoacidosis (DKA).

Elizabeth Gomez, MSN, FNP-BC says:

“It is important they get evaluated if the history is suggestive of Corona in order to track the disease and report to the Department of Public Health. They should be evaluated by a provider if they have a positive history of travel to the affected areas and they have symptoms of fever, cough, shortness of breath or other respiratory symptoms.

Treatment is similar to supportive care but if people have comorbidities (like diabetes) they should follow up closely with the treating provider to prevent complications. The mortality rate is low, so it is expected people will recover well.”

Can the disease be transmitted via injections or fingerpricks? 

The CDC explains that COVID-19 appears to predominantly spread via respiratory droplets, but also may live on various hard surfaces. However, the virus is new, and the spread of the virus is not fully understood yet. Some concerns have been raised about other potential routes of transmission (e.g., blood).

In any case, it is good practice, in general, to never share insulin pens, syringes, or lancing devices and to always change your own syringe or pen needle when injecting insulin, as well as to change your lancet each time you check your blood sugar level.

Conclusions

In general, patients with diabetes are currently advised to follow the same guidelines as the general population when it comes to protecting themselves from the Coronavirus outbreak. Taking care to avoid exposure, as well as common-sense prevention, like washing your hands and not touching your face as much as possible, are key. Be sure to consult your healthcare provider for additional guidance on your specific situation in order to stay safe.

Source: diabetesdaily.com

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