High-Risk Group: Diabetes
Why should I care that I have a high-risk condition?
Those with diabetes are at a much higher risk of developing a severe COVID-19 infection, leading to hospitalization and/or death. Diabetes causes your body to have increased inflammation, weakened immune responses, and decreased circulation [1,2]. Diabetes can also cause damaged or weakened blood vessels, which increase the likelihood of unwanted blood clots to form . Overall, diabetics are 2X more likely to develop severe COVID-19 and 3X more likely to die. 
How does COVID-19 affect a diabetic?
SARS-CoV-2, the virus that causes what we know as COVID-19, is a respiratory virus. While many viruses primarily infect the upper respiratory system (nose, mouth), SARS-CoV-2, can also infect the lower respiratory system (lungs), leading to pneumonia and/or acute respiratory distress syndrome (ARDS), which are deadly in and of themselves. For diabetics, COVID-19 can cause high blood sugars and diabetic ketoacidosis (DKA) . Additionally, COVID-19 can also damage various tissues in organs outside of the lungs from increased inflammation. 30% of COVID-19 deaths are due to heart, liver, or kidney failure .
Can COVID-19 cause diabetes?
New studies have shown alarming evidence that COVID-19 infection may be leading to the development of diabetes among children and adolescents. In a study of over 80,000 individuals, those who became sick with COVID-19 were 166% more likely to develop diabetes than those who had not been infected. No other respiratory viruses have been associated with diabetes .
What can I do?
There are plenty of ways to reduce your risk for COVID-19 infection including vigilant masking, hand washing, and social distancing. While all of these reduce the likelihood you become infected, vaccination is your best option when it comes to the extra protection your body needs to fight off the virus if you do become infected. Be proactive; vaccination is a vital step in protecting yourself when you have a high-risk health condition.
Making a plan for a COVID-19 positive test is also important. You should make sure you have enough groceries and household items, an abundance of simple carbs at home (e.g. soda, honey, jam, etc.) and enough medication and insulin for 14 days. You should also have enough glucagon and ketone strips in case of lows or highs . You may need to check your urine ketone levels to detect if you may be in DKA. Watch for signs of high blood sugar or DKA, which can include increased urination, excessive thirst, nausea or vomiting.
Please talk to your physician for more information to stay prepared and to protect yourself from severe COVID-19.
- Caio Oliveira de Sá-Ferreira, et. al. Diabetic ketoacidosis and COVID-19: what have we learned so far? American Journal of Physiology-Endocrinology and Metabolism 2022 322:1, E44-E53. Dec 22, 2021.
- Mayo Clinic. How does COVID-19 affect people with diabetes. Jan 04, 2022.
- National Heart, Lung, and Blood Institute. COVID-19 and the Blood. November 03, 2021.
- Mantovani, Alessandro, et al. Diabetes as a risk factor for greater COVID-19 severity and in-hospital death: a meta-analysis of observational studies. Nutrition, Metabolism and Cardiovascular Diseases 30.8 (2020): 1236-1248.
- Lim, S., Bae, J.H., Kwon, HS. et al. COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nat Rev Endocrinol 17, 11–30 (2021).
- Tay, M.Z., Poh, C.M., Rénia, L. et al. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol 20, 363–374 (2020).
- Barrett CE, Koyama AK, Alvarez P, et al. Risk for Newly Diagnosed Diabetes >30 Days After SARS-CoV-2 Infection Among Persons Aged <18 Years — United States, March 1, 2020–June 28, 2021. MMWR Morb Mortal Wkly Rep 2022;71:59–65.
- American Diabetes Association. Planning for Coronavirus. Accessed Feb 3, 2022.
- American Diabetes Association. If You Get Sick, Know What to Do. Accessed Feb 3, 2022.