Here are answers to a few questions about the risks associated with COVID-19 for people with diabetes. Note that COVID-19 is a new disease whose many aspects are still being studied.

Topics covered:

Risks for people with diabetes
Diabetes management
Type 1 diabetes
Pregnant women
Work

People living with diabetes are considered “at risk.” What does this mean?

People with weakened immune systems, people aged 70 and older, and people living with a chronic disease, such as diabetes, are considered at risk.

Living with diabetes does not increase the risk of contracting COVID-19, but potentially increases the risk of developing severe symptoms and complications if COVID-19 is contracted. The most common complications are pneumonia and acute respiratory distress. In some cases, COVID-19 can lead to death.

Why are people with diabetes at higher risk of developing severe symptoms and complications if they contract COVID-19?

Viral infections (COVID-19, flu or other) may be more difficult to treat in people with diabetes due to fluctuations in their blood glucose (sugar), especially if their blood sugar level is often high.

Are the risks the same for all people with diabetes?

No, not at all. Certain factors increase the chances of developing severe symptoms and complications of COVID-19:

Being elderly;
Having a body mass index (BMI) equal to or greater than 30;
Having frequent high blood glucose values;
Having complications related to diabetes (for example: kidney or heart problems);
Having other health problems (for example: high blood pressure, lung or liver problems).

Thus, diabetes alone will not necessarily cause a person to develop severe symptoms and complications of COVID-19. To assess the risk, it is important to consider your overall health status. Your health care team is in the best position to do this.

What is the impact of COVID-19 on diabetes management?

Contracting COVID-19 can greatly affect diabetes management, especially in people treated with insulin. Most of the time, this results in hyperglycemia. To better understand the impact of an acute illness on blood sugar and how to manage it properly, consult our article on colds, flu and other infections or our tool, What should you do when you are ill and have type 2 diabetes?

If necessary, contact your pharmacist or doctor to find out if an adjustment to your medication is necessary. Some medications may also need to be stopped temporarily.

Are there any specifics for people with type 1 diabetes?

Organizations such as The BETTER Project and JDRF have gathered a wealth of information specific to people with type 1 diabetes and COVID-19. Visit their websites for more information.

How can a person living with type 1 diabetes prepare if they need to go to the hospital during the COVID-19 pandemic?

People living with type 1 diabetes should not delay going to the hospital if they have major health concerns, especially in the presence of diabetic ketoacidosis. Diabetic ketoacidosis is characterized by hyperglycemia, often greater than 20 mmol / L, with the presence of ketone bodies in the blood or urine.

To facilitate the management of diabetes by hospital medical staff, it is recommended that people with type 1 diabetes carry with them all the information related to the management of their disease.

Click this document for advice on how to properly prepare for a hospital visit, if necessary.

Form to be completed for people with type 1 diabetes treated with multiple insulin injections.

Form to be completed for people with type 1 diabetes who have an insulin pump.

What about children and adolescents living with type 1 diabetes?

Children and adolescents generally account for less than 1% of cases of people infected with COVID-19. They also usually have milder symptoms.

Because of their young age and, for the majority, the absence of complications, children and adolescents with type 1 diabetes are at low risk of COVID-19 causing severe complications.

What about pregnant women living with diabetes and women with gestational diabetes?

Pregnancy and diabetes are two conditions that potentially increase the risk of developing complications from COVID-19. The physiological changes that occur during pregnancy are the reason for this increased risk in pregnant women.

Although studies have found no trace of the virus in the amniotic fluid, placenta or breast milk of infected pregnant or post-partum women, it is still too early to rule out the possibility of obstetric complications due to maternal infection. While waiting to know more, caution is therefore advised.

For now, the recommendations for pregnant women are the same as for the general population. Pregnant women with diabetes or gestational diabetes should pay close attention to their blood sugar since high blood sugar increases the risk of infection.

Is it safe for people living with diabetes to go to work?

The Government of Quebec has recommended teleworking whenever possible. In the event that telework is impossible, the employer must implement preventive measures. The CNESST has produced a toolkit to support workplaces in implementing preventive measures to reduce the risk of contamination related to COVID-19.

Is going to work safe or not? It is impossible to provide an answer that applies to everyone with diabetes since many factors must be considered: general health, type of job being performed, level of risk of contamination in the workplace, etc. A doctor’s advice may be required.

Will people with diabetes who voluntarily withdraw from the workplace be paid?

To date, there is no government financial assistance for people who decide to voluntarily withdraw from the workplace for fear of becoming infected. However, individuals can try to reach an arrangement with their employer or find out about the government assistance measures in place.

Pregnant women with diabetes or gestational diabetes may be eligible for the Safe Maternity Experience Program.

For more details on COVID-19 and work, visit the CNESST website.