Diabetes UK have developed this detailed advice on coronavirus for people living with diabetes with NHS England and NHS Improvement, and Public Health England.
Coronavirus (COVID-19) and diabetes updates
We've created this guidance for people living with diabetes and their families. We hope you find it useful and it answers some of your questions.
How to avoid coronavirus (social distancing)
If you have diabetes, you are at increased risk of severe illness from coronavirus (COVID-19) and according to current government guidance you should be particularly stringent in following social distancing measures, including significantly limiting face-to-face interaction with friends and family if possible.
- Avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or a new and continuous cough.
- Wash your hands regularly for 20 seconds, each time using soap and water, or use hand sanitiser.
- Avoid non-essential use of public transport, varying your travel times to avoid rush hour, when possible.
- Work from home, where possible. Your employer should support you to do this.
- Avoid large gatherings, and gatherings in smaller public spaces such as pubs, cinemas, restaurants, theatres, bars or clubs.
- Avoid gatherings with friends and family. Keep in touch using remote technology instead, such as phone, internet, and social media.
- Use telephone or online services to contact your GP practice or other essential services.
Symptoms of coronavirus
The most common symptoms of coronavirus (COVID-19) are recent onset of a:
- new continuous cough and/or
- high temperature
What to do if you have coronavirus symptoms
If you have coronavirus symptoms, however mild:
- Do not go to a GP surgery, pharmacy or hospital.
- If you live alone, stay at home for 7 days from when your symptoms started.
- If you live with someone who has a continuous cough or a high temperature, you should stay at home for 14 days from the day the first person got symptoms. If you then develop symptoms, you should stay at home for 7 days from the day your symptoms start, even if it means you're at home for longer than 14 days.
- Follow the advice of your GP practice, practice nurse or diabetes team regarding your medication.
- If you routinely check your blood sugar at home you'll probably need to do it more often.
- If you don't check your blood sugar levels at home, be aware of the signs of a hyper (hyperglycaemia), which include passing more urine than normal (especially at night), being very thirsty, headaches, tiredness and lethargy. You should contact your GP practice if you have hyper symptoms.
- Stay hydrated – have plenty of unsweetened drinks and eat little and often.
- If you have type 1 diabetes, check your blood sugar at least every four hours, including during the night, and check your ketones if your blood sugar level is high (generally 15mmol/l or more, or 13mmol/l if you use an insulin pump, but your team may have given you different targets). If ketones are present, contact your diabetes team.
- Keep eating or drinking – if you can’t keep food down, try snacks or drinks with carbohydrates in to give you energy. Try to sip sugary drinks (such as fruit juice or non-diet cola or lemonade) or suck on glucose tablets or sweets like jelly beans. Letting fizzy drinks go flat may help keep them down. If you're vomiting, or not able to keep fluids down, get medical help as soon as possible.
If you feel you cannot cope with your symptoms at home, or your condition gets worse, or your symptoms do not get better after 7 days, then use the NHS 111 online coronavirus service. If you do not have internet access, call NHS 111. For a medical emergency, dial 999.
If you have hospital and GP appointments during this period
Do not go to a GP surgery, pharmacy or hospital if you have coronavirus symptoms even if you have an appointment.
For those who don't have symptoms and want to attend their appointments, the NHS advises everyone to access medical assistance remotely, wherever possible. However, if you have a scheduled hospital or other medical appointment during this period, talk to your GP practice or clinician to ensure you continue to receive the care you need and consider whether appointments can be postponed.
If you miss your annual diabetes review where your 15 healthcare essentials are checked, you should be able to reschedule once normal service resumes. It's ok to miss things such as your eye screening and routine foot checks in these circumstances. But in the meantime, follow your current routine including checking your feet daily, keep to a healthy diet and try to keep active.
If you or your family need to seek medical advice
Seek prompt medical attention if your illness or the illness in any household members is worsening. If it’s not an emergency, go online to use NHS 111. If you have no internet access, you should call NHS 111. If it is an emergency and you need to call an ambulance, dial 999 and inform the call handler or operator that you or your relative have coronavirus symptoms.
All routine medical and dental appointments should usually be cancelled whilst you and the family are staying at home. If you are concerned or have been asked to attend in person within the period you are home isolating, discuss this with your medical contact first (for example, your GP practice, local hospital or outpatient service), using the number they have provided. If your concerns are related to your coronavirus symptoms contact NHS 111 online. If you have no internet access, you should call NHS 111.
Visit the gov.uk website for more information on COVID-19: guidance for households with possible coronavirus infection.
If one of your healthcare team is diagnosed with coronavirus
If your clinician is diagnosed with coronavirus and you have not seen them recently, then you are unlikely to have been exposed to coronavirus. The risk associated with any healthcare workers who become infected with coronavirus is assessed on a case by case basis and appropriate action taken. You should follow the advice given to you if you are contacted because you have been exposed to coronavirus in this way.
Coronavirus and your emotional wellbeing
You might be feeling worried and anxious about coronavirus and how it might affect you or your family and friends. We know this could be a stressful time, so you may need support with how you’re feeling.
We have some helpful information to help you cope with stress and other emotions, or you might like to call our helpline to talk it through with someone. We also have a useful coronavirus thread on our online forum, where members are sharing information and experiences so you might find answers to any more questions.
How coronavirus can affect people with diabetes
Coronaviruses can cause more severe symptoms and complications in people with diabetes, as well as in older people and those with other long-term conditions, such as cancer or chronic lung disease.
Everyone with diabetes, including those with type 1 and type 2, is more at risk of severe complications if they develop coronavirus, but the way it affects you can vary depending on what type of diabetes you have.
When you have diabetes, being ill can make your blood sugar go all over the place. Your body tries to fight the illness by releasing stored glucose (sugar) into your blood stream to give you energy. But your body can’t produce insulin to cope with this, so your blood sugars rise.
Your body is working overtime to fight the illness, making it harder to manage your diabetes. This means you’re more at risk of having serious blood sugar highs and lows, as well as longer-term problems with your eyes, feet and other areas of your body.
For most people, coronavirus is a mild illness, but some people develop a more serious form of the virus, and could die.
It is important that people with diabetes follow the sick day rules should they become ill from any illness. If you routinely check your blood sugar at home, you'll probably need to do it more often – at least every four hours, including during the night.
If your blood sugar is persistently high or low, or if you have symptoms of a hyper contact your GP practice or diabetes team by phone who will help you if you have any queries or if you are unsure about what to do regarding your diabetes.
Children with diabetes
Everyone, including children with diabetes can get coronavirus. NHS guidance states that anyone under 70 with an underlying health condition, including diabetes, is at increased risk of severe illness from coronavirus and should be particularly stringent in following social distancing measures.
If you are pregnant
The same rules apply to you as for everyone with diabetes. If you’re pregnant and have diabetes, then you are more at risk of getting the virus. This is because you’re more vulnerable to getting infections and illnesses. It's really important you follow the government advice and limit face-to-face interaction as much as possible.
If you’re worried about things like going to your antenatal appointments, you can find all the latest information about this and more from the Royal College of Obstetricians and Gynaecologists.
If you are in type 2 diabetes remission
Diabetes remission works differently for different people, and we still don't know enough about it. So we don't know for sure what your risk of developing the virus is and given that you have had a diagnosis of diabetes in the past, you remain at risk.
You can find more general information in our guide to type 2 diabetes remission.
Work and coronavirus
Current government guidance is that employees of all ages with diabetes, including those under 70, should be strongly advised – and supported by employers – to stay at home and work from there if possible. And those people with diabetes who follow advice to stay at home and who cannot work as a result will be able to get statutory sick pay (SSP), even if they are not sick. The government advice is being updated all the time, so visit gov.uk to find all the latest information about sick pay, self-employment advice and benefits.
For more general information and support about your rights at work, see our guide to work and diabetes.
We know lots of people are worrying about holidays they’ve booked and whether they’re more at risk if they do travel. We’ve also had questions about whether it’s safe to see friends or family who have travelled from affected areas.
The Foreign Office has the most up-to-date information. As of 17th March, they are advising British nationals against all but essential international travel. Any country or area may restrict travel without notice.
If you look after or live with someone who has diabetes
We recommend everyone follows the NHS advice around reducing the risk of picking up infections including thoroughly washing your hands frequently, practicing good hygiene and avoiding contact with people who are unwell.
If you live with someone who has a continuous cough or a high temperature, you should stay at home for 14 days from the day the first person got symptoms. If you then develop symptoms, you should stay at home for 7 days from the day your symptoms start, even if it means you're at home for longer than 14 days.
If you have been in close contact with someone with confirmed coronavirus, use the NHS 111 online coronavirus service.
Source: Diabetes UK 20th March 2020