Does diabetes increase your risk of coronavirus?

New studies

According to new NHS research, a third of COVID-19 deaths in England are associated with diabetes. People living with type 1 diabetes are three and a half times more likely to die in hospital with coronavirus than people who don't have diabetes. People with type 2 diabetes are twice as likely as someone without the condition to die from COVID-19.

The risk of death increases with age for people with diabetes, as is consistent across the population. More people with type 2 diabetes have died from coronavirus than those with type 1 - people with type 2 diabetes are more likely to be older and have other health problems.

In both types, even with other risk factors taken into account, higher blood sugar levels and obesity were linked to increased risk of death.

However, whilst the study has found that the risk is higher for people with diabetes, it's important to remember that the overall risk of dying from coronavirus is small. Most people who catch coronavirus, diabetes or not, will have a mild infection and recover. A small proportion will need hospital care and an even smaller proportion will die from COVID-19. But just because most people experience a mild illness, it doesn't mean that we shouldn't take the virus seriously.

Staying at home

Everyone should still be staying at home as much as possible and following strict social distancing measures if they do come into contact with other people. This means staying at least two metres apart from people outside your household and minimising trips out as much as possible.

If you live in England, you are now allowed to meet with one person at a time outside of your household under new regulations but you should make sure that this is in an open outdoor space and that you maintain your distance. This minimises the risk of passing on coronavirus to each other if you are carrying it asymptomatically.

Those who have symptoms of coronavirus or who are shielding should not leave their home for any reason. People who have diabetes aren't in the group instructed to 'shield' for twelve weeks as they are not classed as 'clinically extremely vulnerable', unless they have other health conditions which put them into this category. However, people with diabetes are 'clinically vulnerable' and so should follow social distancing rules as much as possible.

Patient picks for COVID-19

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With lockdowns a thing of the past, COVID-19 may not be at the forefront of everyone's minds - but it is continuing to spread. And as long as it does so, mutations of the virus, often referred to as different variants, will continue to emerge. Here we look at what we know about the two new strains, Eris and Pirola.

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Long COVID

Most people with COVID-19 infection (SARS CoV-2 infection) feel better within a few days or weeks and recover completely within 12 weeks of the infection. However, some people have ongoing symptoms that remain for weeks, months, or longer, which is usually called "long COVID". For some, these long-term effects of COVID-19 can be debilitating. These effects can be very different from person to person, and it seems likely that there are different 'types' of long COVID, or different syndromes, which might behave in different ways.

by Dr Doug McKechnie, MRCGP

What if I do catch coronavirus?

Regardless of whether you have diabetes, if you have any symptoms of COVID-19, including a cough, temperature or loss of smell or taste, you should self-isolate and not leave your house for at least seven days from the start of your symptoms. Anyone you live with should stay at home for fourteen days from the start of your symptoms or seven days from the start of their own symptoms. Anyone in the UK who has symptoms of coronavirus can now book a test online to find out if they have it.

Illness and your medicines

There are some medicines used for diabetes which may need to be stopped temporarily when you have COVID-19 symptoms. You should check with your GP as soon as you develop symptoms if you are taking:

• SGLT-2 inhibitors (canagliflozin, dapagliflozin, empagliflozin or ertugliflozin).

• Metformin.

• ACE-inhibitors or ARBs (sometimes called 'Sartans').

• Diuretics.

• Non-steroidal anti-inflammatory drugs (for muscle and joint problems).

Illness and your blood sugar

Being ill can affect the blood sugar levels of people with diabetes as the body works harder to fight off illness. This is why there is an increased risk of being seriously unwell with COVID-19.

You should follow the advice of your GP, practice nurse or diabetes team about the management of your diabetes, including medication, whilst you are ill. Whether you have symptoms of COVID-19 or any other condition, it's worth being up to speed with the 'sick day rules' for diabetes. You'll need to check your blood sugar more frequently if this is something you can do from home.

If you have type 1 diabetes, check your blood sugar and ketones at least every four hours, including during the night. Remind yourself of the symptoms of DKA (diabetic ketoacidosis).

If you have any of these symptoms, contact your GP practice or in the UK call 111 out of hours. If you have diabetes and have these symptoms, contact your diabetes team. If you feel very unwell, in the UK call 999 immediately.

Treating your symptoms

Most people are able to treat their coronavirus symptoms at home. You should keep trying to eat and drink whilst you're unwell. Try to maintain a healthy and balanced diet and lifestyle where you can, and drink plenty of water throughout the day to stay hydrated.

If you become unable to cope with your coronavirus symptoms at home, you feel worse or you aren't better after a week, you should use Patient's coronavirus checker tool to find out what to do next. In an emergency, call 999. If you do have to go to hospital, tell someone that you have diabetes so that they can arrange appropriate care for you.

Managing your diabetes during the pandemic

It's important, as always, to stay on top of managing your diabetes. Many routine appointments have been cancelled or postponed during the pandemic. You'll be able to reschedule your annual diabetes reviews, eye screenings and foot checks at a later date if they get cancelled. However, in the meantime you should make sure to keep up with your regular routines to stay healthy. This includes daily foot checks, a healthy diet and active lifestyle.

If you have diabetes and have been asked to go to appointments, especially about foot or eye problems, you should still attend. Clinicians will make sure that it is safe to for you to do so. It is important to be seen so that problems don't get worse.

If you have any concerns about managing your diabetes whilst unwell, you can still arrange a telephone or video appointment with your GP or contact your diabetes team. If you notice problems with your feet like a cut or blister, contact your GP or call 111 if you can't get through. Speak with your optometrist or local screening service if you notice any changes to your vision.

If you are unable to leave your house to pick up prescriptions because you are shielding or self-isolating because of coronavirus, you can contact your pharmacy to find out if they are delivering prescriptions. NHS volunteers are also able to collect and deliver your prescriptions if necessary.

Diabetes UK has more detailed information on diabetes and coronavirus on its website.