Diabetes and COVID-19

Diabetes is a major risk factor for heart disease and consequently many people living with diabetes are also living with heart conditions. It is unclear if having diabetes puts you at greater risk of contracting COVID-19 than anyone else, however it does increase your risk for complications if you contract the virus. Recent data from the Department of Health has highlighted that 23% of all ICU admissions due to COVID-19 have underlying diabetes. Having diabetes causes the body to raise glucose levels during times of illness or stress which makes it more difficult to fight infection.

To reduce your risk of contracting COVID-19 you need to be extra vigilant by following the advice of the HSE and taking the recommended precautionary measures. You should be aware of the signs and symptoms of the virus, and if do become unwell phone your doctor to arrange an assessment and testing.

Be prepared

Be extra attentive to your glucose control and monitor on a regular basis if you have a blood glucose monitor. Regular monitoring can help avoid complications caused by high or low blood glucose levels. Ensure to have a supply of quick acting carbohydrates if your blood glucose levels drop, these include non-diet sugary drinks, fruit juice, jelly babies and glucose tablets.
There is no disruption to the supply of medicines and therefore there is no need to order more medicines than you need. However, you should make sure you have a 2 week’s supply. Supplies should include ketone strips if you have type 1 diabetes and an insulin pen if you use an insulin pump in case of pump failure.
Ensure you have a sick day regime to follow. This is a plan that has been agreed between you and your health care provider, with information and advice about how you should manage your diabetes if you become unwell. If you don’t have one you should contact your GP for advice.

Diet and emotional eating

A healthy, balanced and varied diet is important for everyone, but especially so for people with diabetes. During these uncertain times, you may find it more difficult to maintain a healthy diet. With more time at home, increased stress and worry, and reduced activity, you may find that your normal food intake has changed and diabetes management has become much more challenging.

It’s important to keep to a structured meal pattern as much as possible. Here is where a little planning will go a long way. Try to jot down a general plan of meals and snacks for the week ahead, and base your shopping list off of this.

Generally, aim to have 3 main meals, spaced throughout the day with 1-2 healthy snacks if needed. However, if you find you have a reduced appetite you may be under-eating, it can be best to have a “little and often” approach such as 3 smaller meals with 3 more nutritious snacks that are higher in energy. Both approaches will not only help to stabilize blood sugars throughout the day, but will also help you keep your appetite, or physical hunger levels in check. This in turn will help to prevent under or over eating. See our list below for snack ideas.

Healthy low calorie snack ideas:
• A piece of fruit and low fat plain yoghurt
• Hummus and vegetables
• A small handful of nuts (30g)
• ¼ avocado on 2 rice cakes
• Hard- boiled egg
• Low fat cottage cheese with fruit

Higher calorie snack ideas:
• Full fat Greek yoghurt with nuts and seeds
• Peanut butter on wholegrain toast
• ½ avocado on 4 rice cakes
• A 200ml glass of full fat milk
• A matchbox of cheese on wholegrain crackers

For healthier sweet treats that have less impact on blood sugar levels:
• Home baking using zero calorie sweeteners such as Stevia or Canderal
• Sugar free jelly
• A couple of squares of dark chocolate
• Low fat Greek yoghurt with peanut butter and raspberries
• Sugar free soft drinks

It is important to stay hydrated and aim to drink about 2 Litres of water per day. For those trying to increase their appetite, it is best for now to avoid too much caffeine and artificial sweeteners as these can suppress appetite.

Exercise

Continuing to exercise is beneficial for your physical and mental health and importantly it helps improve diabetes control through the lowering of blood glucose levels. If you previously went to the gym or swimming, consider cycling or walking but be sure to follow social distancing recommendations and stay within 5km of your home. You could also try one of our online exercise programmes.

If you take medications that put you at risk of a hypo (this is when your sugar levels become too low and you can feel unwell) make sure you carry a fast acting carbohydrate snack and monitor your blood sugar levels as you normally would.
Ensure you check your feet after exercise for red marks and blisters, this is because individuals living with diabetes often have reduced sensation in their feet and are at increased risk of foot infections and injury.

Routine appointments

Many appointments have been cancelled or postponed due to the COVID-19 outbreak, this is to reduce the risk of infection for both patients and staff members. If you were due to attend for retinal screening, chiropody or your annual diabetes review, your appointment will be rearranged once it is safe to do so. However, your GP is still available and you should phone if you have any concerns, questions about your medication, or if you notice or develop any of the following:
• Changes to eyesight
• Consistently high or low blood glucose readings.
• Red, bruised or broken areas to your feet
• Signs of infection or you become unwell

Medication

You should continue to take your diabetes medication as normal. If you have any concerns it is important that you link with your GP who will connect you with the Diabetes team where necessary.

Further information

Further information on COVID-19 and diabetes can be found here: