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Diabetes and COVID-19: What to do if you get sick

Severe illness from COVID-19 is more likely in people who have certain underlying medical conditions. One of these is type 2 diabetes. According to the Centers for Disease Control and Prevention (CDC), it is also possible that people with type 1 or gestational diabetes are at higher risk.

And the danger goes both ways. Being ill may also make it harder for people with diabetes to control their blood sugar. So, if you have diabetes, it is a good idea to know what to do in case you get sick.

Plan ahead in case of illness

“Make sure you always have plenty of insulin and groceries for at least the week ahead,” said Karrie Benda, clinical dietitian with the Aspirus Riverview Diabetes & Nutrition Center in Wisconsin Rapids. “Be sure you're stocked up on supplies of simple carbohydrates like regular soft drinks, honey, jam, gelatin, hard candies or frozen pops. These can help keep your blood sugar up in case you feel too sick to eat. If you are feeling well enough to eat complex carbs, that is the healthiest option, but resorting to simple carbohydrates may be necessary if you are extremely nauseous or have a severe sore throat.”

If you use insulin, you should also keep a supply of glucagon and ketone strips on hand, as well as rubbing alcohol and soap to wash your hands.

Also, talk with your health care provider ahead of time about what steps to take if you start to feel unwell. Ask questions like:

  • How often should I check my blood sugar?
  • When should I check for ketones?
  • Should I make any changes in my diabetes medications?

If you do get sick

The first thing to do if you suspect you have COVID-19 is to call the Aspirus COVID-19 Call Center at 1-844-568-0701 or 1-715-843-1454. Be sure to tell them you have diabetes. The Call Center staff will tell you what to do next - for example, where and how to get tested. You may also call your health care provider’s office.

“If you have COVID-19, you will need to manage your blood sugar as well as possible,” said Benda. “Keep taking your diabetes medicines as usual and follow your health care provider's advice. Also, stay hydrated. If you are having a hard time keeping water down, try taking small sips every 15 minutes or so. It would be wise, however to call your provider’s nurse for advice if you experience such severe vomiting and diarrhea that you are unable to keep anything in you for eight hours or more.”

Follow your health care provider’s advice about how often to check your blood sugar. If you use a continuous glucose monitor, keep in mind that some devices are affected by acetaminophen. You may need to do finger sticks to ensure you are getting the right readings.

  • If your blood sugar is low, eat 15 grams of simple carbs. Confirm that your blood sugar is on the rise with a 15-minute recheck.
  • If your blood sugar is high more than two times in a row, check your urine for ketones. If ketones are present, call your health care provider's office right away. You may need to go to the emergency room to be treated for diabetic ketoacidosis.
  • Wash your hands often. And clean your injection and fingerstick sites with rubbing alcohol or soap and water.

Is it an emergency?

According to CDC, you should go to the emergency room if:

  • You are having trouble breathing.
  • You have moderate to high ketone levels in your urine.
  • You cannot keep liquids down for more than four hours.
  • You lose 5 pounds or more while sick.
  • Your blood sugar is lower than 60 mg/dL.
  • You are too sick to eat normally and cannot keep food down for more than 24 hours.
  • You are vomiting or have severe diarrhea for more than six hours.
  • Your temperature is above 101 degrees for 24 hours.
  • You feel sleepy or cannot think clearly. If this is the case, call 911 or ask someone else to drive you.

To learn more about diabetes care at Aspirus, visit aspirus.org/diabetes-care or call the Aspirus Customer Contact Center at 800.847.4707.