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Coronavirus: Specific guidance for people living with diabetes

If you live in Hammersmith and Fulham, Kensington and Chelsea, Westminster, Ealing, Hounslow, Brent, Hillingdon and Harrow and have diabetes or are at risk of type 2 register your interest in the Know Diabetes service today.

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Coronavirus: Specific advice for people living with diabetes

Having diabetes does NOT mean you are more likely to catch coronavirus.  However, if you do catch coronavirus, 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

As of 24th March 2020, the Government advice is for everybody to stay at home to stop coronavirus spreading.

Previously people at high risk of developing more severe symptoms from coronavirus were being advised to self-isolate. Now everyone is to stay at home – even if you do not have any symptoms of other health conditions.

You can only leave your house for the following reasons:

  • To shop for basic essentials – only when necessary
  • To do one form of exercise – this is limited to once a day
  • For medical needs – to visit a pharmacy or deliver supplies to a vulnerable person
  • To travel to and from work – only where this is absolutely necessary

If you have to leave your home for any of the reasons above, you need to wash your hands as soon as you get home.

You should also ensure you stay 2 metres (6 ft) apart from anyone outside your household when doing these activities.

These measures are to reduce day-to-day contact with other people to reduce the rate of transmission of coronavirus.

You can find more about this new guidance and what it means by looking at this leaflet from the UK Government.

What should I do if I have symptoms (self-isolating)?

As of 16 March anyone developing symptoms consistent with COVID-19 (new continuous cough or high temperature), however mild, should stay at home for 7 days from the onset of symptoms as per existing advice. It’s important not to go to your GP surgery, hospital or a pharmacy if you think you may have coronavirus. You do not need to be tested for COVID-19. 

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. A useful summary of these (courtesy of the Primary Care Diabetes Society) is shown below.

Sick Day Rules for Diabetes

Information for pregnant women and their families, please refer to this source. 

It’s important not to go to your GP surgery, hospital or pharmacy if you think you may have coronavirus, please use the NHS 111 online tool or dial NHS 111 for further medical advice.

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, but 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 which makes it harder for you to manage your diabetes. This can increase your 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. It is important that people with diabetes follow the sick day rules for type 1 and type 2 and use the NHS 111 online coronavirus tool or dial NHS 111 for further medical advice.

Shielding advice

Shielding is a way to protect those that are extremely vulnerable and at a very high risk of severe illness from coronavirus. This involves staying at home and avoiding all face-to-face contact for at least 12 weeks. Those that are classed as extremely vulnerable are people with certain types of cancer and severe respiratory conditions. To find out more about shielding and who should be following this advice, please check the UK Government website.

Some people with diabetes may also need to follow this shielding advice if they have other medical conditions, for example, those with kidney disease or cystic fibrosis-related diabetes. However, under the current advice, most people with diabetes do not need to shield. If you have not had any instructions from the NHS to shield then you should follow the stay at home guidance.

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 your 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 your sick day rules provided by your diabetes educator team
  • Stay hydrated – have plenty of unsweetened drinks and eat little and often

Practical advice to help you right now

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
  • Keep up to date with the advice from Diabetes UK which you can find here
  • All people with diabetes should self isolate.

Don't

  • Touch your eyes, nose or mouth if your hands are not clean
  • If you haven't stopped smoking, now is a good time to do so​. Most stop smoking support teams are still providing a remote service.

Some specific advice for healthcare professionals (HCPs) and people with diabetes:

  • Guidance for Health professionalsClinical guide for the management of people with diabetes during the coronavirus pandemic
  • Guidance for Primary Care, Secondary Care,  Community Health, Social Care and Ambulance services
  • People with diabetes are at elevated risk of acquiring the more severe disease
  • Keep up to date with the advice from Diabetes UK which you can find here
  • All diabetes consultations to be done virtually by HCPs to minimise the risk of exposure unless otherwise indicated
  • If people haven't stopped smoking, advise that now is a good time to do so
  • All people with diabetes should self isolate.
  • Guidance for healthcare professionals on coronavirus (COVID-19) infection in pregnancy, published by the RCOG.