Diabetes and the Coronavirus

Jan 30, 2021

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By Kathy Strom, RN, CDE, William Newton Hospital Diabetes Educator

Whether you get a cold or COVID, illness can make it harder to manage diabetes. Working out a plan for sick days may help prevent a minor illness from having serious consequences. Kathy Strom

When ill, the body releases hormones that help fight off the disease. Unfortunately those hormones interfere with the ability of insulin to lower blood sugar. Abnormally high blood sugar levels can lead to serious complications that can lead to a coma if left untreated. Many infectious organisms feed on sugar so the vicious cycle continues.

You and your diabetes team can work together to develop a sick day plan before you become ill.

1. Even if your blood sugar is usually in good control it is important to check it often when you become sick. For example, test every 6 hours for a mild illness and every 2-3 hours for a severe illness.
2. If you use insulin, be sure to check for ketones every 4-6 hours or if blood sugar is higher than 240 more than 2 times in a row. Keep a log of your test results to report to your healthcare team if needed.
3. Continue to take your diabetes medications even when you are sick unless your diabetes care team tells you not to. Do not skip your diabetes pills or insulin even if you feel too ill to eat.
4. If you take insulin, your diabetes care team may tell you to take extra insulin. Even if you are vomiting or unable to eat, continue taking your long-acting insulin. Your dose may have to be adjusted while sick.
5. If you take diabetes pills take your usual dose. If you are unable to keep them down consult your diabetes team. Some medications may need to be stopped for a while. These may include metformin, sulfonylureas (glyburide, glimepiride, glipizide) or Farxiga, Invokana and Jardiance.
6. Check with your pharmacist before taking over-the-counter medicines like aspirin, cough syrup or decongestants as many of these can raise or lower your blood sugar as well.
7. Try to stick with your normal meal plan if possible. If unable to, try eating some of the foods listed below. Each contains about 15 grams of carbs. Try to eat or drink at least 45 grams of carbs every 3-4 hours.
   • ½ cup fruit juice
   • ½ cup regular (not sugar free) pop
   • ½ cup regular jello
   • 1 double popsicle
   • 1 cup soup
   • 1 slice toast
   • 1 cup sports drink
   • 6 saltine crackers

If unable to eat solid foods, be sure to drink 6-8 ounces of liquids every hour. Switch back and forth between drinks that contain sugar and those that do not.

Call your diabetes care team if:

• Your blood sugar level is less than 70
• Your blood sugar level is over 240 for more than 2 tests in a row
• Unable to keep fluids down
• Have a fever over 101 for more than 24 hours
• Have severe pain in stomach, have chest pain, or have a hard time breathing
• Vomiting or having diarrhea more than 3 times in 24 hours
• Have moderate amounts of ketones after more than 1 test As always, the best treatment for illness is to avoid it, so remember to wear a mask around others, wash your hands often, and social distance as much as possible.

Getting sick can be a challenge for someone with diabetes, but a little pre-planning and preparation can help make an illness a little less stressful.

Editor's Note: This article was submitted by William Newton Hospital for the Cowley CourierTraveler Health & Wellness Guide published January 2021.