The novel coronavirus known as COVID-19 has upended the world. The entire country of Italy is on lockdown and Americans are being asked to stay indoors as much as possible, only venturing out for essential supplies like food and medicine.

People with compromised immune systems, like older adults and those with chronic medical conditions like diabetes, are particularly vulnerable to COVID-19. While safety precautions are the same as the flu, this virus is a much more serious illness. For people with diabetes, this means taking particular precautions to avoid the virus.

In this Q&A, Maria E. Peña, MD, Director of the Diabetes Alliance at The Mount Sinai Hospital, provides advice for people living with diabetes on how to navigate the world during the COVID-19 pandemic.

Why are people with diabetes more vulnerable to infections and complications of infections?

Diabetics have a compromised immune system which means that fighting viral infections takes longer and is more taxing on the body. Additionally, a report from the International Diabetes Federation found that viral infections cause fluctuations in blood glucose, making diabetes harder to control. And, viruses may thrive in environments of elevated blood glucose.

However, it is important to remember that although diabetics are more likely to experience complications when infected, it is unclear if diabetics are at a greater risk of contracting the virus.

What should people with diabetes do to prepare?

Patients should be sure to have all of their medications refilled as soon as possible, this also includes testing supplies for blood glucose self-monitoring. Additionally, if you are one of the many diabetes patients who has high blood pressure, be sure to have an at home blood pressure monitor.

As more potential cases arise, health care providers will be focused on caring for the sickest patients and office staffing may decrease. Therefore, there may be delays in refills. To avoid this, request that your pharmacy give you a 90-day supply of all medications. Additionally, be sure to have your doctor’s office contact information in case you have questions about your medication, blood sugar, or you are not feeling well.

Apart from making sure medications and medical supplies are on hand, what other precautions should diabetics take?

I recommend that diabetics create an emergency contact list of family members, neighbors, and/or friends who are aware of their medical history and medication list and can drive them to a hospital if necessary.

Additionally, avoid large public gatherings and designate someone to do your essential food shopping. Plan to have enough food and water in case you need to quarantine for several weeks. Hydration is particularly necessary when glucose levels are elevated.

Also, be sure to have soda, juice, and candy available in case your glucose levels drop rapidly. Patients with type 1 diabetes should ensure that they have glucagon kits that are not expired.

COVID-19 is a serious viral infection that appears to be more infectious than the flu and has no vaccine or antiviral to shorten its duration. Diabetics, and other immunocompromised people, should take detailed appropriate precautions to avoid possible infection.

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