Tips for Managing Diabetes in the COVID-19 Pandemic
The COVID-19 pandemic is already one of the most devastating pandemics in recent memory. Everyone is at risk of contracting COVID-19.
In addition, if you are living with diabetes, you have a higher risk of developing serious complications with COVID-19. This is especially if your blood sugar levels are not well controlled.
Managing your diabetes well can help to protect you against the worst effects of COVID-19. Here are some tips to help you manage your diabetes and take preventive steps during the COVID-19 pandemic.
1. Stay up-to-date on COVID-19 and follow recommendations for preventing infection
Firstly, take steps to protect yourself from becoming infected.
STAY INFORMED on the latest developments in the rapidly changing COVID-19 pandemic. Use official websites and beware of FAKE news.
FOLLOW recommendations: 1
Observe good hand hygiene
Minimise going out
If you do need to go out, wear a mask, avoid crowded places and practise safe physical distancing (at least 1 metre apart)
2. Make sure you have enough medications and supplies (but don't stockpile!)
To minimise trips to the doctor or pharmacy, ensure that you have enough medications and supplies (including insulin needles, glucose test strips and lancets for blood sugar tests) to last until your next medical appointment, and one month longer.
Don't stockpile medications or supplies because they may expire. Adequate stocks will be available when you need them.
If you are running out of medications and supplies, please contact the clinic to refill your medications at least two weeks before they run out so that there is sufficient time to process your prescription requests and for your medications/supplies to reach you.
3. Improve or maintain control of your blood sugar levels to reduce your risk of severe infection
Keeping your blood sugar levels within recommended levels (4-10 mmol/L)2 may help to reduce the severity of COVID-19 infection for people who get the disease.
Staying at home during the pandemic presents both advantages and challenges for maintaining good control of your blood sugar levels. While at home, continue to take your medications regularly and periodically monitor your blood sugar levels using a glucose meter.
Check your finger-prick blood sugar levels at least two days a week (before and/or 2 hours after meals and at bedtime). You may need more frequent monitoring if your blood sugar levels are unstable, or if you have been instructed by your healthcare team do so.
Take advantage of this time at home to gain better control of your diet, including making healthier food choices and eating more home-cooked meals that follow the healthy-plate principle.
On the other hand, you probably won't be able to go to the gym and may be walking less. Try to keep up your physical activity levels with indoor exercises. For an added motivational boost, invite a buddy to participate in an indoor steps or other exercise challenge with you, and update each other by instant messaging or video calls.
4. Rescheduling your doctor's appointment or doing a tele-consult
Discuss with your doctor whether your next doctor's appointment can be safely postponed, or whether your visit can be replaced with a tele-consult.
Monitoring your blood sugar at home can help your healthcare team to monitor your diabetes and adjust your treatment through tele-consult.
You can record your blood sugar readings using a log-sheet like this, or use an app (on your phone) which allows you to export your records as a report.
You may also use dedicated software programmes to download the readings from your device and export them as a report. You can use these reports during your discussion with your healthcare team. For example, if you use one of the following devices:
FreeStyle Optium Neo glucose meter
Accu-Chek Guide glucose meter
Style Libre flash glucose monitoring system
If you are using your phone as a reader, download the FreeStyle LibreView software onto your desktop. Log-in to view your results.
Or use a third party software such as Tidepool
5. Know your sick-day plan
Firstly, if you're feeling sick, you should see a doctor at a Public Health Preparedness Clinic (PHPC) or a polyclinic.
In addition, as someone living with diabetes, you may experience changes in your blood sugar levels if you get sick with COVID-19 or other illnesses. Your sick-day plan tells you how to detect and manage these blood sugar changes. For example, you may need to monitor your blood sugar more often and adjust some of your medications that could cause problems when you are sick.
If you're not sure what your sick-day plan is, you can refer to this plan.pdf , which is suitable for most people with diabetes.
If you have type 1 diabetes, speak to your diabetes doctor about developing an individualised sick-day plan for your specific needs.
Take steps to protect your childSo far, children (including those with diabetes) seem to be less likely than adults to get COVID-19 or, if they fall sick, often have a milder form of the disease. If your child has diabetes, you can take steps mentioned above to help manage your child's diabetes during the COVID-19 pandemic. Keeping good sugar control will help reduce the risk and severity of COVID-19. You may be tempted to skip your child's regular doctor's visits during the pandemic. Before skipping appointments, talk to your child's doctor and ask whether you and your child can do tele-consult instead. Tele-consult could help your child's doctor to review your child's blood sugar control and insulin dose, and identify any issues. This is especially important for younger children. If your child falls sick, they should follow their sick-day plan. This includes more frequent monitoring of blood sugar and ketone levels if they have type 1 diabetes. If you are a patient of NUH Paediatrics, please contact the Diabetes Nurse Educators if you need help when your child is sick. |
1 These recommendations are current as of April 2020. Please check the MOH COVID-19 website for the latest recommendations.
2 Or follow the targets set by your doctor for you.