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What People with Diabetes Need to Know About COVID-19

If you have diabetes, you’re used to putting in extra effort to manage your health. Now, there’s a new wrinkle: It appears people with diabetes are more prone to complications from coronavirus disease 2019 (COVID-19).

“If you have diabetes, you really don’t want to get COVID,” says UNC Health endocrinologist John B. Buse, MD, PhD. “Diabetes is linked to more severe cases of the disease.”

Healthcare providers are still trying to determine exactly why, but what they do know is that people with diabetes can take extra steps to protect themselves.

The Link Between Diabetes and COVID-19 Complications

It does not appear, according to the best available data, that people with diabetes are more prone to contracting the coronavirus, Dr. Buse says. In fact, epidemiologists think the rate of infection is the same among people with and without diabetes: about 10 percent.

The difference comes in the risk of severe illness. People with diabetes “might be at twice the risk of being hospitalized if they contract COVID,” Dr. Buse says. “Diabetes is overrepresented in the ICU (intensive care unit) population.”

That means people with diabetes are more likely to need intensive treatment, such as a ventilator to help them breathe, and they are more likely to die, according to early statistics from the pandemic.

But it’s also important to note, Dr. Buse points out, that most people with diabetes who get COVID-19 will recover, even most people who are hospitalized.

Why the increased risk? People with type 2 diabetes often have other conditions that make them vulnerable, Dr. Buse says. They tend to be older and have a high body mass index. “If I had to guess, the risk in people with diabetes is related to obesity and hypertension and heart disease more so than what their blood sugar is,” he says.

As for those with type 1 diabetes, they are at greater risk of serious illness from common infections such as the flu, and this probably applies to COVID-19 as well, Dr. Buse says. Though because type 1 diabetes is typically diagnosed in younger people and not related to obesity, this group has fewer of the additional risk factors that affect people with type 2 diabetes.

What’s important is that no matter what kind of diabetes you have, you can work to get it or keep it under control and maintain your blood glucose levels in a healthy range.

Interestingly, the physical stress of being hospitalized or having surgery can cause someone without diabetes to have such a large blood sugar spike that he or she needs to be treated with insulin, Dr. Buse says. This is called “stress hyperglycemia,” and it essentially amounts to temporary diabetes. It’s most common in people who are likely to later develop type 2 diabetes.

How to Protect Yourself from COVID-19 if You Have Diabetes

This additional risk should be taken seriously, but you don’t need to feel disheartened or fearful if you have diabetes, Dr. Buse says. In fact, you can feel empowered that there are steps to take to stay healthy.

To avoid getting the virus, people with diabetes should do the same things as everyone else: Practice physical distancing, wash hands frequently, and wear a mask in public places or when coming within 6 feet of someone.

If you have diabetes and you develop a fever, call your doctor, Dr. Buse says. This is especially true if you also develop a cough. People with shortness of breath need immediate medical attention, but they should call ahead to the doctor or the hospital’s emergency department so medical staff can prepare for a possible COVID-19 case.

If you notice your blood sugar is high for a few days but you have no symptoms of COVID-19, take your temperature and call your doctor. This could be an early warning sign of infection, Dr. Buse explains.

Dr. Buse tells people with diabetes that if they do end up in the hospital, it’s good to take their medications and blood sugar monitoring supplies with them. If you’re only mildly ill and can do some tasks yourself, such as taking your medication, it will help your care team because they won’t have to dress in full protective gear just to deliver a pill. Of course, you will still receive attentive care throughout the day and night.

Speaking of the hospital: Doctors are concerned about reports that people are staying home during medical emergencies such as heart attacks because they’re afraid of being exposed to the virus. It’s critically important to get help right away if you have symptoms of a heart attack or stroke, Dr. Buse says.

Don’t skip your diabetes-related visits to your primary care provider or endocrinologist, either.

“We want people to take care of their diabetes just like they would the rest of the time and not just focus on COVID,” Dr. Buse says. “If you’re doing OK and don’t need bloodwork, we can do a virtual visit. We can safely do face-to-face visits for people whose diabetes is uncontrolled or those who need a blood draw.”

Dr. Buse worries about people with diabetes who might fall through the cracks during this time of isolation. He encourages his patients to stay in touch and stay vigilant.

“Stay focused, and don’t worry about the things you can’t do anything about,” he says. “Concentrate on what you know is good for you.”


For the latest information on COVID-19, visit the CDC website and the UNC Health COVID-19 Resources page, and follow UNC Health on Twitter, Facebook, Instagram and YouTube.