Coronavirus: specific advice for people with diabetes

Web Resource Last Updated: 09-03-2021

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. As cases are starting to fall, there have been some changes to what you can and cannot do:

  • You can spend time in outdoor public spaces for recreation on your own, with your household or support bubble, or with one other person. 
  • Pupils and students in all schools and Further Education settings should return to face-to-face education
  • Wraparound childcare can reopen and other children’s activities can restart only where it is needed to enable parents to work, attend education, seek medical care or attend a support group. Vulnerable children can attend childcare and other children’s activities in all circumstances
  • Students on practical Higher Education courses at English universities who have not already returned and would be unable to complete their courses if they did not return to take part in practical teaching, access specialist facilities or complete assessments will be able to return
  • Those seeking to leave the UK must complete an outbound declaration of travel form ahead of departure
  • The rules on visiting care homes have changed to allow regular indoor visits for a single named visitor

National Lockdown still in place

England is still in a national lockdown. You must stay at home, leaving only where permitted by law, however, some of the rules on what you can and cannot do have changed.

You can only leave your home for essential reasons which include:

  • Shopping for basic necessities, for you or a vulnerable person
  • Go to work if you cannot work from home
  • Exercise, or for outdoor recreation in a public outdoor space - this can be on your own, with your household or support bubble or with one other person (in which case you should stay 2m apart). 
  • To meet your support bubble or childcare bubble where necessary, but only if you are legally permitted to form one
  • Seek medical assistance or avoid injury, illness or risk of harm (including domestic abuse)
  • Attend school or further education
  • Attend university or other higher education - for those eligible
  • Attend, or take a child to, childcare - for those eligible

If you do leave home for a permitted reason, you should always stay local in the village, town, or part of the city where you live. You may leave your local area for a legally permitted reason, such as for work.

If you are clinically extremely vulnerable you should only go out for medical appointments, exercise or if it is essential. You should not attend work

To read the full guidance on what you can and cannot do, please see the UK Government website. *Please note these tiers are applicable to England, please see the guidance for Wales, Scotland and Northern Ireland*

Meeting others

You may leave your home for exercise or to visit a public outdoor place for recreation. This must be on your own, with your household or support bubble or with one other person when in a public outdoor place. You should minimise the time you spend outside your home for this, and you should not travel outside your local area.

Stay 2 metres apart from anyone not in your household or support bubble and follow the guidance on how to stop the spread of coronavirus at all times.

Education

From 8 March, all pupils and students should attend face-to-face education in primary schools, secondary schools and further education settings such as colleges. Secondary pupils, further education college students and staff will be offered regular testing from 8 March.

University students undertaking practical or practice-based courses who require specialist equipment and facilities can attend face-to-face teaching and learning with regular testing now in place. All other students should continue to learn remotely.

You can find all of the latest news from the government about coronavirus on their website.

Travel

You must not leave your home unless you have a reasonable excuse (for example, for work or education purposes). If you need to travel you should stay local – meaning avoiding travelling outside of your village, town or the part of a city where you live – and look to reduce the number of journeys you make overall. 

If you need to travel, walk or cycle where possible, and plan ahead and avoid busy times and routes on public transport. This will allow you to practice social distancing while you travel. Please see the safer travel guidance from the UK Government for further information on how to stay safe as a passenger.

For further guidance on travelling, please see the UK Government website.

Vaccinations

The NHS is currently offering COVID-19 vaccines to people at the highest risk of becoming seriously unwell and dying from COVID-19.

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.

Hands. Face. Space.

Approximately 1 in 3 people who have coronavirus have no symptoms and could be spreading it without realising it.

Remember - ‘Hands. Face. Space.’

  • Hands – wash your hands regularly and for at least 20 seconds
  • Face – wear a face-covering in indoor settings where social distancing may be difficult, and where you will come into contact with people you do not normally meet
  • Space – stay 2 metres apart from people you do not live with where possible, or 1 metre with extra precautions in place (such as wearing face coverings)

In all circumstances, you should follow the guidance on meeting others safely.

Wearing a face covering

Face coverings are mandatory in all indoor settings and public transport. Under the new rules, people who do not wear a face-covering will face a fine of up to £100. Children under 11 and those with certain disabilities will be exempt.

The liability for wearing face-covering lies with the individual. To see the UK Government advice about face coverings please click here.

What should I do if I have symptoms?

Do not leave home if you or someone you live with has any of the following: A high temperature, a new, continuous cough, a loss of, or change to, your sense of smell or taste.

Most people with coronavirus have at least one of these symptoms.

Phone your GP if your symptoms:

  • are severe or you have shortness of breath
  • worsen during home isolation
  • have not improved after 7 days

If your GP is closed, use the NHS 111 online coronavirus service or phone NHS 24 (111). In addition, it is now recommended that all individuals living in the same household as an asymptomatic person should self-isolate for 14 days (household isolation). Information on COVID-19, including “stay at home” advice for people who are self-isolating and their households, can be found on the NHS website

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.

You can find help on HM GOV website if you’re struggling because of coronavirus, for example with paying bills, being out of work or taking care of your mental health. You can also sign up to get emails when they change any coronavirus information on the GOV.UK websites

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

If you are clinically vulnerable, you could be at higher risk of severe illness from coronavirus and advised to follow the latest shielding advice.

Those who are clinically extremely vulnerable should not attend work, school, college or university, and limit the time you spend outside the home. You should only go out for medical appointments, exercise or if it is essential.

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
  • Maintain social distancing according to government guidelines on what you can and can’t do
  • Read more about staying safe outside your home on GOV.UK.
  • Cover your face by wearing a face mask over your nose and mouth in enclosed spaces

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.

Most routine appointments such as your annual diabetes review have been delayed or postponed for just now. These will be rescheduled once the situation returns to normal. In the meantime keep up your routine of checking your feet, keeping to a healthy diet and doing some physical activity in line with the lockdown 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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