Diabetes & COVID-19

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Diabetes & COVID-19

The CDC has determined that people with diabetes are at higher risk for getting very sick if they contract COVID-19. Below is general guidance on COVID-19 as it relates to people with diabetes; however, we advise you consult your doctor for the most current guidance and recommendations on specific aspects of your treatment. You can also read more about COVID-19 vaccination.

Risks of COVID-19 & Diabetes

Currently, it does not appear people with diabetes are more likely to be infected with COVID-19. However, we do know that people with diabetes do face a higher chance of serious complications from COVID-19.

If diabetes is well-managed, the risk of severe illness is similar to that of the general public. If diabetes is not well-managed and blood sugars fluctuate, the risk for diabetes-related complications increases. Having heart disease or other illnesses in addition to diabetes could worsen the effect of COVID-19, like other viral infections, due to your body’s ability to fight off an infection is compromised. Viral infections can also increase inflammation in people with diabetes. This leads to above-target blood sugars, and could also contribute to complications.

When sick with a viral infection, people with diabetes face an increased risk of DKA (diabetic ketoacidosis), most common in people with type 1 diabetes. DKA can make it difficult to manage fluid intake and electrolyte levels – which is key to managing sepsis. Sepsis and septic shock are two serious complications experienced by those with COVID-19.

It does not appear COVID-19 affects people with type 1 and type 2 diabetes differently. Symptoms and risk varies by age, complications and how well diabetes is being managed.

Symptoms of COVID-19

Symptoms include fever, cough, and shortness of breath – similar to what you may feel with influenza or a bad cold. You can find more information on symptoms here. If you feel like you are developing symptoms, call your doctor.

When you call:

  • Have your glucose reading available
  • Have your ketone reading available
  • Keep track of your fluid consumption and report
  • State your symptoms clearly
  • Ask your questions on how to manage your diabetes

Managing Diabetes While Feeling Sick

If you have COVID-19 or think you may have COVID-19, it is important to keep taking your diabetes medications or insulin as prescribed. These medications may need to be adjusted to keep your glucose or blood sugar on target. There are a few things you should, including:

  • Drink extra water and other calorie-free beverages (i.e. unsweet tea, diet lemonade, sugar-free soda) when sick. If having trouble keeping water down, drink small sips every 15 minutes. Keep hydrated.
  • Try to follow your meal plan. If not eating well, eat small portions of “comfort foods” every 1-2 hours such as a small bowl of soup, ½ cup custard or pudding, 5 vanilla wafers, ½ cup of applesauce or ice cream, ½ cup of juice, or ½ cup hot cereal. Liquid or soft food may be easier to keep down.
  • Track blood glucose more often. Check every 4 hours and keep a log. Write time, date and blood glucose results. There are many tracking apps available to use with smartphones (i.e. Glucose Buddy, MyFitnessPal, BlueStar Diabetes). If you do not have a glucose meter or a continuous glucose sensor, consider buying an over-the-counter meter at your local pharmacy. If you are unable to check your blood glucose level, ask someone to help.
  • Check for ketones in your urine if you are sick with blood glucose over 240 mg/dl more than 2x in a row. Keto sticks are found at drug stores if not already in your sick-day box. If trace or small ketones (turns a little pink or light pink on the strip after urine placed on it) keep drinking water and checking your blood glucose every few hours until ketones are negative or gone in the urine.

Insulin & Medical Supplies

Manufacturers are reporting no impact on current manufacturing and distribution for insulin and supplies at this time, but that is subject to change. If you are struggling to pay for insulin or know someone who is, the American Diabetes Association has resources to help at InsulinHelp.org.

Visiting the ER or Hospital

If you visit the ER or get admitted to the hospital with COVID-19, please bring ALL diabetes supplies such as glucose meter, strips, continuous glucose monitor, insulin pump with extra supplies in case you need to be admitted to the hospital.

If in the hospital, be involved in your diabetes care by letting the nursing staff know if your blood glucose is fluctuating using the direction arrows on your continuous glucose meter, by your finger stick readings or if having symptoms of high or low blood glucose.

Medication needs will change while in the hospital. Some may be increased, reduced, eliminated, or brand changed. You may be prescribed insulin for the first time while in the hospital to assist in your blood glucose control. This is all part of getting well.


If you have any questions, please contact your physician's office, or contact the diabetes educators at the Harold Hamm Diabetes Center by calling (405) 271-1000.