Coronavirus: specific advice for people with diabetes

Web Resource Last Updated: 19-07-2021

Contents

Having diabetes does NOT mean you are more likely to catch Coronavirus.  However, if you do catch Coronaviruses, it can cause more severe symptoms and complications in people with diabetes. More severe symptoms are also likely in older people, and those with other long-term conditions such as cancer or chronic lung disease.

Latest Updates

What's changed?

The government has published the ‘COVID-19 Response - Spring 2021’ setting out the roadmap out of the current lockdown for England. England has moved to Step 4 in the roadmap which means that most restrictions have been lifted. This means that:

  • You do not need to stay 2 metres apart from people you do not live with. There are also no limits on the number of people you can meet.
  • However, in order to minimise risk at a time of high prevalence, you should limit the close contact you have with those you do not usually live with, and increase close contact gradually. This includes minimising the number, proximity and duration of social contacts.
  • You should meet outdoors where possible and let fresh air into homes or other enclosed spaces.
  • The Government is no longer instructing people to work from home if they can. However, the Government expects and recommends a gradual return over the summer.
  • The requirement to wear face coverings in law has been lifted. However, the Government expects and recommends that people wear face coverings in crowded areas such as public transport.
  • There are no longer limits on the number of people who can attend weddings, civil partnerships, funerals and other life events (including receptions and celebrations). There is no requirement for table service at life events or restrictions on singing or dancing. You should follow guidance for weddings and funerals to reduce risk and protect yourself and others.
  • There are no longer restrictions on group sizes for attending communal worship. COVID-19 has not gone away, so it’s important to remember the actions you can take to keep yourself and others safe. Everybody needs to continue to act carefully and remain cautious.

Although most legal restrictions have been lifted at step 4, and many people have been vaccinated, it is still possible to catch and spread COVID-19, even if you are fully vaccinated, and we are still in the third wave of this pandemic in the UK.

**Please be aware that this guidance is relevant to England only. Please check the relevant Governement websites for Scotland, Northern Ireland and Wales for their latest advice regarding coronavirus.**

Keeping yourself and others safe

While cases are high and rising, everybody needs to continue to act carefully and remain cautious. This is why the UK Government are keeping in place key protections:

  • testing when you have symptoms and targeted asymptomatic testing in education, high-risk workplaces and to help people manage their personal risk.
  • isolating when positive or when contacted by NHS Test and Trace.
  • border quarantine: for all arriving from red list countries and for those people not fully vaccinated arriving from amber list countries.
  • cautious guidance for individuals, businesses and the vulnerable whilst prevalence is high including:
    • whilst Government is no longer instructing people to work from home if they can, Government would expect and recommend a gradual return over the summer
    • the Government expects and recommends that people wear face coverings in crowded areas such as public transport
    • being outside or letting fresh air in
    • minimising the number, proximity and duration of social contacts.
    • encouraging and supporting businesses and large events to use the NHS COVID Pass in high-risk settings.
    • the Government will work with organisations where people are likely to be in close proximity to others outside their household to encourage the use of this. If sufficient measures are not taken to limit infection, the Government will consider mandating certification in certain venues at a later date.

Meeting others

Indoors:

Almost all legal restrictions are being lifted on 19 July.

This means an end to the "rule of six" - including how many friends you can have at your home, or meet at a pub. It also means an end to capacity limits at events.

The government says people should still "consider the risks of close contact", particularly if someone is clinically extremely vulnerable, or not fully vaccinated.

Social distancing is still required in certain circumstances:

  • When travellers enter the country, before border control
  • Hospitals and care homes may use it to reduce the chance of infections

Outdoors:

  • You should meet outdoors where possible and let fresh air into homes or other enclosed spaces, however, restrictions on group sizes have been lifted.

For more information please see the UK Government website here

Travel

There are no restrictions on travel within England.

You should check the rules at your destination if you’re planning to travel to Scotland, Wales or Northern Ireland, or to Ireland or the Channel Islands as there may be restrictions in place.

Do not travel if you have COVID-19 symptoms or are self-isolating. Get a test and follow the stay at home guidance.

Vaccinations

All adults in England have now been offered at least one dose of a COVID-19 vaccine. The vaccines are safe and effective. They give you the best protection against COVID-19. 

If you have not yet received the COVID-19 vaccine, you should get vaccinated. It usually takes around two to three weeks for an antibody response to develop. You need two doses of vaccine for maximum protection against COVID-19.

Book your coronavirus vaccination appointments online.

You can also book appointments at a larger vaccination centre or a pharmacy that provides COVID-19 vaccinations.

Covid vaccines and diabetes

The vaccines have been shown to reduce the likelihood of severe illness in most people. If you have diabetes, Diabetes UK strongly encourages you to get the coronavirus vaccine and take whichever vaccine you're offered. This is because people with diabetes are vulnerable to developing a severe illness if they do get coronavirus, and vaccines are the most effective way to prevent that from happening.

For more information about coronavirus vaccines and diabetes, have a look at the Diabetes UK website.

Wearing a face covering

COVID-19 spreads through the air by droplets and aerosols that are exhaled from the nose and mouth of an infected person.

The requirement to wear face coverings in law has been lifted. However, the Government expects and recommends that people wear face coverings in crowded areas such as public transport.

What should I do if I have symptoms?

If you develop COVID-19 symptoms, self-isolate immediately and get a PCR test, even if your symptoms are mild.  You should self-isolate at home while you book the test and wait for the results.

You must self-isolate if you test positive. Your isolation period includes the day your symptoms started (or the day your test was taken if you do not have symptoms), and the next 10 full days. This is the law.

The most important symptoms of COVID-19 are the recent onset of any of the following:

  • a new continuous cough
  • a high temperature
  • a loss of, or change in, your normal sense of taste or smell (anosmia)

For most people, COVID-19 will be a mild illness. However, if you have any of the symptoms above, even if your symptoms are mild, stay at home and arrange to have a test.

You must also self-isolate if you are told to do so by NHS Test and Trace, for example, if you have come into contact with someone who has tested positive. This remains the law, regardless of your vaccination status.

If you have diabetes and start to feel unwell you need to follow the sick day rules for type 1 or type 2 and check your blood glucose frequently.

How coronavirus can affect people with diabetes

Everybody that has diabetes, no matter whether type 1, type 2 or gestational, is at risk of developing a severe illness if they get coronavirus, but the way it can affect you varies from person to person.

When you are ill and have diabetes, your blood glucose levels can be unstable as your body is trying to fight the illness. Your body starts releasing stored glucose into your bloodstream to give you energy. As a person with diabetes, your body either cannot produce insulin or the insulin you produce doesn't work as well. This causes your blood glucose levels to rise further. There is a risk of both high and low blood glucose levels as your body is working overtime to fight the illness.

For most people, the coronavirus causes a mild illness, but some people can develop a more serious form of the virus which can be life-threatening.

SGLT2i medication

If you have type 2 diabetes and you take SGLT2i tablets (medication that ends in 'flozin'), your doctor may want you to stop taking these for just now. This is because SGLT2i tablets can mask the symptoms of DKA (diabetic ketoacidosis) which can be caused by coronavirus.

If you have type 2 diabetes and take SGLT2i tablets, you can keep taking these unless you become unwell. If you are unwell, these tablets could increase your risk of developing diabetic ketoacidosis. 

There are lots of different types of SGLT2i tablets so have a look at Diabetes UK for the full list of brand names.

Shielding advice

Clinically extremely vulnerable people are advised to follow the same guidance as everyone else. However, as someone who is at a higher risk of becoming seriously ill if you were to catch COVID-19, you should think particularly carefully about precautions you can continue to take.

These precautions are included in the guidance for the clinically extremely vulnerable.

Other tips to keep safe and well 

If you have type 1 diabetes:

  • Ensure you have enough glucose and ketone testing equipment
  • Be aware of you sick day rules provided by your diabetes educator team
  • Make sure you have a good stock of insulin pens, needles and any other medications you are prescribed
  • Stay hydrated – have plenty of unsweetened drinks and eat little and often
  • If you are an insulin pump user you should have insulin pens as a backup and a good supply of insulin pump consumables
  • Make sure your diabetes technical device  (insulin pump /continuous glucose monitor/Freestyle Libre device) is in good working order and if you have any concerns phone the company who supplies your device directly to troubleshoot and arrange a replacement if necessary.

If you have type 2 diabetes:

  • Ensure you have enough glucose testing equipment and, if appropriate, ketone testing strips (this might be if you have had your diabetes for a long time or have had ketones in the past). Ketones are uncommon in type 2 but remain a risk if glucose is high for a significant time &/or during illness.
  • Make sure you have a good stock of your medications, orals tablets &/or injectable therapies.
  • Be aware of you sick day rules provided by your diabetes educator team
  • Stay hydrated – have plenty of unsweetened drinks and eat little and often

For the most up-to-date advice then keep checking the UK government and NHS websites.

Additional JDRF advice for Type 1 diabetes can be found here.

To avoid catching or spreading Coronavirus:

Do:

  • Wash your hands with soap and water frequently – wash for at least 20 seconds
  • Always wash your hands when you get home or into work
  • Use hand sanitiser gel if soap and water isn’t available
  • Cover your mouth and nose with a tissue when you cough or sneeze
  • Put used tissues in the bin straight away and wash your hands
  • Cover your face by wearing a face mask over your nose and mouth in crowded areas such as public transport

Don't

  • Touch your eyes, nose or mouth if your hands are not clean
  • Do not use pocket handkerchiefs as these are unhygienic, instead use single-use tissues.

If you have hospital and GP appointments

Do not go to the GP surgery, pharmacy or hospital if you have coronavirus symptoms. If you are having treatment for something such as an eye or foot problem and you do not have coronavirus symptoms, then your appointments should still carry on unless you have been contacted to cancel it. If you are in any doubt then phone the number on your appointment letter.

The NHS and medical services remain open, including:

  • dental services
  • opticians
  • audiology services
  • chiropody
  • chiropractors
  • osteopaths
  • other medical or health services, including services relating to mental health

The NHS continues to carry out urgent and non-urgent services safely. It is vital anyone who thinks they need any kind of medical care comes forward and gets help.

Keep up your routine of checking your feet, keeping to a healthy diet and doing some physical activity in line with the restrictions. If you notice something different that you are concerned about such as a cut or blister to your foot, call your GP and let them know. If you cannot get through then call 111 for advice. If you have a change in your vision you should get in touch with your local screening service or optometrist. 

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