Coronavirus (Covid-19)

Advice for people with diabetes and their families

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Updates: Coronavirus and diabetes

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Updated 13 April: We recently updated this page with new information about the availability of coronavirus self-testing kits in England

This page is up to date but we will continue updating it regularly as we find out more information from the government.

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Coronavirus (Covid-19) and diabetes updates

We've created this information for people living with diabetes and their families. We hope you find it useful and it answers some of your questions. We'll keep updating this page and you can find all our other coronavirus news stories in our News Hub.

All the information below applies to the whole of the UK, unless specified. We've noted where are some differences in guidance and diabetes services across the UK.

How coronavirus can affect people with diabetes

If you have diabetes – regardless of what type you have – you are no more likely to catch coronavirus than anyone else. And the majority of people who do get coronavirus – whether they have diabetes or not – will have mild symptoms and don’t need to go into hospital. 

However everyone with diabetes, including those with type 1, type 2, gestational and other types, is more vulnerable to developing a severe illness if they do get coronavirus, but the way it affects you can vary from person to person. In children, the risk of becoming seriously ill with coronavirus is very low.

For most adults, coronavirus is a mild illness. But some people develop a more serious illness and sadly could die. Research shows us that there are certain risk factors that make people with diabetes at higher risk, like being older, having a high HbA1c, or having a history of diabetes-related complications. There are other factors too, like your BMI and ethnicity, that research shows can have an impact on your risk.

There are some risk factors that you can't change, but others where you can reduce your risk.

Being ill can make your blood sugar go all over the place. Your body tries to fight the illness by releasing stored glucose (sugar) into your blood stream to give you energy. But your body can’t produce enough or any insulin to cope with this, so your blood sugars rise.

Your body is working overtime to fight the illness, making it harder to manage your diabetes. This means you’re more at risk of having serious blood sugar highs and lows, potentially leading to DKA (diabetic ketoacidosis) or HHS (hyperosmolar hyperglycaemic state).

How to reduce your risk of getting seriously ill from coronavirus

The UK government is reviewing lockdown restrictions for the UK on a regular basis, and there are different rules for different areas. You can find out more about the rules in EnglandWalesScotland and Northern Ireland, but everybody should continue to: 

  • wash hands regularly, for 20 seconds 
  • wear a face covering 
  • stay 2 meters away from people outside your household.

People in England can get two free coronavirus test kits each week. These tests are available to encourage people without coronavirus symptoms to test themselves regularly.

The government has produced a step-by-step guide for people with visual impairment, on how to use and return your test kits.

Getting the coronavirus vaccine

The most important way people living with diabetes can lower their risk of becoming seriously ill from coronavirus is to avoid catching the virus in the first place. A vaccine is the most effective way to prevent infection, and that’s why we strongly encourage you to get the vaccine when you’re offered it.

People in group six, which includes people with diabetes, are now being invited to have their vaccine.

If you are in priority group six and live in England, you no longer have to wait to be invited for your vaccine. You can now also book an appointment online to receive your vaccine or call 119 free of charge, anytime between 7am and 11pm seven days a week.

Get more information about the coronavirus vaccines, including who can get it and how safe it is for people with diabetes.

Face masks and coverings

Some of you have been asking us whether people with diabetes need to wear face masks and coverings. Some research shows that they can slow the spread of the virus, by protecting others from catching something you may be carrying. This is true for everyone, including people with diabetes. 

Get one of our adjustable face coverings from our online shop.

There are certain reasons why some people don’t need to wear a face covering – called exemptions. These include children (depending on their age), if you have asthma, and lots more. But these exemptions are different depending on where you live, so check your national government websites for the most up-to-date list – we've added some useful links below. If these exemptions apply to you, then you don’t need to wear one. But if nothing on the list applies to you, then there’s no reason why you shouldn’t wear a face covering. 

We know it’s not that simple. Wearing a mask can take some getting used to, and can feel very strange at first. Some of you have told us that wearing a mask makes you feel anxious or you find it hard to breathe. There are lots of different masks out there so try to find one that suits you best. You also could try wearing it around the house for a bit, to get used to breathing in it and moving about while it’s on.

If you spot someone not wearing a mask when they’re out and about, try not to make a judgement – there could be lots of invisible reasons for this and it’s not something that’s in your control. Some people may prefer to have something to hand that says they don't need to wear a face covering. You can print these from the UK Government website or make the message your phone screensaver.

Managing your blood glucose (sugar) levels

Research has shown that having a high HbA1c can increase your risk of becoming seriously ill from coronavirus. So it’s important to work with your diabetes team to try to bring your blood sugar levels to a healthy range.

We've explored some of the research behind reducing your risk, including vitamin D supplements.

If you get coronavirus

If you do get coronavirus, it’s really important that you follow your sick day rules. This will help you to keep your blood sugars in range as much as possible, so you can stay well and fight the virus. We know it’s not that always that simple. Take a look at our new courses in Learning Zone to help you remember your sick day rules and manage your blood sugar levels, and our guide on staying home and managing diabetes.

Some people are being treated for coronavirus with a steroid called dexamethasone, which can make your blood sugars go high. Find out more about the steroid dexamethasone and diabetes.

Remember, for urgent medical help, call 999.

"Thankfully this past week I’ve been feeling much better and I’m not as short of breath. My symptoms have definitely been in line with those of Covid-19 but I suppose I’ll never know for definite if I’ve had the virus!"

- Khadija has diabetes and recovered from coronavirus symptoms – read her story

How coronavirus can affect children with diabetes

Although children can catch the virus, they normally have very mild symptoms and we are not aware of any children with diabetes who have died from coronavirus. However, as with all people with diabetes, an illness like coronavirus can make it harder to manage your child’s diabetes and they still have a risk of DKA. So it's important that you make sure your child follows social distancing and handwashing recommendations to reduce their risk of catching it. 

Get more information about children and school.

How coronavirus can affect pregnant women with diabetes

The same rules apply to you as for everyone with diabetes. If you’re pregnant and have diabetes, then you are not more at risk of getting the virus. However, if you do get the virus, you could be more at risk of developing complications and it could become harder to manage your diabetes. For that reason, it's really important you're extra careful and follow social distancing rules.

You can find all the latest information for pregnant women from the Royal College of Obstetricians and Gynaecologists.

How coronavirus can affect people in type 2 diabetes remission

Diabetes remission works differently for different people, and we still don't know enough about it. So we don't know for sure how the virus could affect you if you’re in remission. Everyone, including people in diabetes remission, should carefully follow social distancing rules. You can find more general information in our guide to type 2 diabetes remission.

How coronavirus can affect people from Black, Asian and minority ethnic groups

The risk of death from coronavirus for some ethnic groups is higher than for people of white ethnicity. But it is important to remember that there are lots of factors involved, like age, and overall risk of dying from coronavirus is very low. 

In England and Wales, data from the Office of National Statistics shows how people from certain Black, Asian and minority ethnic (BAME) groups are more at risk than people of white ethnicity. Research in Scotland hasn’t shown this increased risk, but the BAME population there is very small. And we don’t have data on this in Northern Ireland at the moment.

Data from Office of National Statistics. Covid-19 deaths by ethnicity in England and Wales between 2 March and 10 April 2020.
Data from Office of National Statistics. Covid-19 deaths by ethnicity in England and Wales between 2 March and 10 April 2020.

We don’t know why this is happening. The data takes into account factors which we know can increase risk, such as age, socioeconomic status and health, including obesity. And we do know that some ethnic minority groups are more at risk of developing conditions like type 2 diabetes and heart problems, which are linked to increased risk of death from coronavirus. 

It’s clear that we need further research to understand what’s causing this – whether the causes are physical, cultural or social. We are pushing for clearer guidance from the government on risks to people from ethnic minority backgrounds.

Coronavirus deaths in people with diabetes

Data from NHS England in May showed us that, for those who become so unwell with coronavirus that they need to go to hospital, the risk of dying is higher for people living with diabetes than people without the condition. But the risks aren't the same for everyone with diabetes. Most deaths have been in the elderly with very few under the age of 50 and none in children.

This study only looked at the number of people who have died in hospital as a result of coronavirus. It doesn’t include information on the many thousands who have recovered at home or who have been successfully discharged from hospital. We are calling on the government and NHS to ensure this data is used to update guidance and policies to keep people who are at greatest risk protected and supported. Research has shown us that people with diabetes who have the highest risk of becoming seriously ill or dying from coronavirus are those over the age of 50, who have a high HbA1c (above 75mmol/mol or 9%) and have received treatment for diabetes complications.  

Here our Head of Research Communications, Dr Lucy Chambers, explains more about the risk factors, including type of diabetes, age and ethnicity, and why for most people your risk of dying remains very low. Although this research is England based, we believe this level of risk will be true in all nations. And to find out more detail on these statistics, go to our coronavirus deaths in people with diabetes news story.

We’re funding research projects looking at the specific ways coronavirus affects people living with diabetes. We know there’s a lot more to learn about this new type of virus, and we know we need answers fast.

 

Can coronavirus cause diabetes?

There is growing evidence to suggest that coronavirus might be triggering diabetes in some people, or making the condition worse for others. We've taken a look at the research so far and explain what scientists are doing to find answers.

Shielding – advice for clinically extremely vulnerable people

Shielding is a way of protecting 'clinically extremely vulnerable' people who are at a very high risk of severe illness and needing to go to hospital if they catch coronavirus. It means staying at home almost all of the time, with no face-to-face contact.  

As governments begin to ease their lockdowns, the advice for clinically extremely vulnerable to shield will be coming to an end.

Governments in England, Scotland, Wales and Northern Ireland have each set out their own provisional plans for easing lockdown. These plans lay out changes to the guidance on shielding for people listed as clinically extremely vulnerable.

Wherever you live, it’s still really important to keep following the coronavirus guidance in your area and to shield if you feel it’s right for you.

England

In February, the UK Government adopted a new approach in England to predict the risk a person has from becoming seriously unwell from coronavirus. This involves a new risk tool called QCovid Population Risk Assessment, which has made it possible to identify people at higher risk through their medical records and quickly alert both them and their healthcare teams. 

This new tool identified an extra 1.7 million people in England who should have now been asked to shield. Some people in this group will have diabetes.

This entitles these people to get their coronavirus vaccine earlier, and to get support from the government to shield, specifically furlough from work and Statutory Sick Pay.

The government has said that the advice for clinically extremely vulnerable people to shield will stop after 31 March.

People in the clinically extremely vulnerable group who haven’t already had a first dose of their coronavirus vaccine will be invited to come forward by the NHS as a priority.

It's important to remember that not everyone in England who has diabetes is now considered clinically extremely vulnerable or has been asked to shield.

If you're in England and have diabetes but have not been contacted about being moved into the clinically extremely vulnerable group, any lockdown rules where you live will stay the same for you as they are for people who don’t have diabetes.

If you’re worried about anything to do with shielding our helpline team is here to support or provide more information. Call 0345 123 2399 to speak to one of our highly trained advisors about any questions or concerns.

In February, we held a Facebook Live where our panel of diabetes experts answered your questions about the vaccine and about shielding. Find out what questions were asked about shielding here.

Scotland

There is a national lockdown in Scotland, called enhanced Level 4 restrictions. This means everyone must stay at home as much as possible. You can find the detailed rules on the government website.

If you're clinically extremely vulnerable and being advised to shield, you should get a shielding letter with extra advice on how to stay safe. This includes working from home and not going to the shops. Get all the latest updates about shielding from the Scottish government website.

The guidance to shield will end from 26 April.

Wales

All of Wales is currently under Alert Level 4 restrictions. Find out more about these rules on the government website.

Those who are clinically extremely vulnerable should have got letters with advice on how to stay safe, including things like working from home. Here’s the latest Welsh government advice for people who are clinically extremely vulnerable, including where you can get more support with things like food supplies.

After 1 April, clinically extremely vulnerable people in Wales won’t be asked to shield anymore.

Northern Ireland

Government advice for everyone is to stay at home as much as possible.

The advice for people who are clinically extremely vulnerable in Northern Ireland and working, is to stay at home even if you can't work from there. But this advice is coming to an end on 12 April. Find more information on the Northern Ireland government website.

Going to work

The government advice is that people should work from home if possible. If you're not able to work from home and still need to go to your workplace, your employer needs to take the right steps to make the workplace safe, to minimise risk to employees.

In some areas of the UK, some people who are clinically extremely vulnerable are being advised to stay at home even if they can't work from home. 

If you can’t work from home and have diabetes

Your employer must make sure your workplace is safe – this means doing a risk assessment at work. We know that some people with diabetes don't feel safe going back to work, so we're pushing the government on making it safer.

Some people with diabetes are classed as clinically extremely vulnerable and there are different rules on this depending where you live. This means some people may qualify for a furlough scheme or things like sick pay – take a look at our section on shielding for information based on where you live.

We've got more information about your rights in our diabetes and work guide.

If you can’t work from home and have a child with diabetes

Similarly to a workplace assessment, your child's school must do a risk assessment at school when they reopen. Some schools may remain open for children of key workers. We've got more information on children and school during the pandemic.

If you’re a parent with diabetes working at home

We know some of you are worried about your child bringing the virus home from school when they reopen, and that’s understandable. Use our quick and easy Learning Zone coronavirus course to learn how to keep yourself well. And make sure you know what your child's school should be doing about maintaining social distancing.

"I've been unsure as to what I was supposed to be doing, but the school said they don’t expect to see me for the foreseeable future. It was really nice to get that reassurance."

- Jon talked to us about managing diabetes and working as a teacher during lockdown, read his story

Children and school

Everyone, including children with diabetes, can get coronavirus. The rules about on social distancing and hand washing apply to children with diabetes too.

Schools should be practicing social distancing for your child. This is to prevent the virus from spreading between children and your home. We know this is easier said than done, and can depend on how old your child is and the size of the school. 

You may be worried about whether it is safe for your child to go to school if they have diabetes. Speak to the school and to your child’s diabetes team about your concerns. And read our guide for parents on what you should expect from your child's school – including doing a risk assessment and having the right policies in place.

While the risk of children with diabetes becoming seriously ill with coronavirus is very low, we’ve been in touch with the Department for Education to raise your concerns and ask that when their school-specific guidance is published – it includes guidance on supporting children with health conditions too.

Going to appointments or into hospital

If you have coronavirus symptoms, do not go to a GP surgery, pharmacy or hospital even if you have an appointment.

If you're already having treatment for something like a foot or eye problem, and you don't have coronavirus symptoms, then your appointments should still carry on. If you're worried about going to your clinic or hospital at this time or want to check whether your appointment is still going ahead, call the number on your appointment letter or speak to your GP.

It's likely that most appointments with your diabetes healthcare team will be on the phone or online, using a video call. There are some groups of people who need to be seen face-to-face more than others at the moment. Your diabetes healthcare team will give you advice on the best type of appointment for you at this time. Having a phone or video appointment might feel strange if you're not used to it but we've got advice on preparing for a remote appointments

Most routine appointments like your annual diabetes review have been delayed or postponed. But you should be able to reschedule once things go back to normal. In the meantime, follow your current routine including checking your feet daily, keep to a healthy diet and try to keep activeEye screening is still going ahead in some circumstances and for some people who are at higher risk of problems, such as pregnant women with diabetes. All eye screening clinics should be using personal protective equipment (PPE).

And remember to get your free flu jab as early as possible. Speak to your GP or go to your local pharmacy. Find out more about the flu jab.

If you are invited to an in-person appointment it’s very important to attend unless you develop coronavirus symptoms. This is to make sure you stay as healthy as possible during the pandemic. Health professionals will be wearing PPE and observing social distancing where possible. 

"Flu increases the risk of needing to go into hospital for people with diabetes so we must do all we can to keep protected against flu this year. That's why the free NHS flu jab is so important." 
Dan Howarth, our Head of Care and Diabetes Specialist Nurse

If you spot something new you're concerned about, like a cut or blister on your foot, call your GP and explain your situation. If you can't get through, call 111 for advice. If you have any change in your vision you should contact your local screening service or optometrist.

You may be in a situation where you need medical attention – this may be something related to your diabetes, or it may be something unrelated like an injury or illness. This means you might have to go to the Accident and Emergency (A&E) department of your local hospital and you might have to wait a while before being seen.

During this time, your care in hospital may be a little different to normal, for example you may not see the diabetes team or not have family with you when you go into hospital. For any problem, regardless of the current situation, you should go to hospital as you would've done before – the NHS is still open. Read our guide to managing your diabetes while in hospital.

Travel

Travel restrictions differ depending on where you live, so we recommend you check the appropriate guidance before travelling:

The Foreign and Commonwealth Office currently advises British nationals against all but essential international travel. Check the UK government website for the latest rules on travelling. You could also check the TravelHealthPro website for the latest travel health guidance.

Take a look at our guide to travelling when you have diabetes for lots more information, including travel insurance to cover coronavirus.

Getting food, medicines and tech

We know some people have had challenges getting access to food deliveries and the food you need to stay healthy. We have written to the major supermarkets and are actively monitoring the situation. 

You’ve also been asking about medicines and diabetes technology. There is no need for the public or NHS to stockpile insulin, diabetes medicines or tech. This could cause shortages and put other patients at risk. Pharmacies have been asked to not support patients trying to stockpile. Get more info about picking up prescriptions.

The government has been working with industry and partners to monitor the impact of coronavirus on the UK supply chain of medicines and technology and put in place measures to protect UK patients. This includes banning companies from buying medicines like insulin that are meant for UK patients and selling on for a higher price in another country. This will help to ensure an uninterrupted supply of crucial medicines like insulin for NHS hospitals treating coronavirus patients.

We want to reassure you that if you’re using an insulin pump, a continuous glucose monitor or a flash glucose monitor (a FreeStyle Libre), you will still be able to get these – whether that’s usually through prescriptions or you pay for these yourself. And if your insulin pump warranty is due to expire soon, the companies who make these will extend this or supply a replacement if that’s needed at any point.

For those who need or choose to buy test strips, we have negotiated with several companies to make certain strips available through our catalogue and online shop.

We know some people have had challenges getting access to food deliveries and the food you need to stay healthy. If you live in an area which is in Tier 3 or Tier 4 restrictions, and you are shielding, you can register for support to get priority deliveries. Given the extra demand supermarkets face in the Christmas period, priority deliveries are not currently guaranteed, so you may find it easier to order your shopping delivery as you would normally. 

If you have not been told to shield, or you live in an area that isn’t in Tier 3 or Tier 4 restrictions, you should contact your local council. They may be able to offer support to help you get the food you need. You can also contact NHS Volunteer Responders, who can arrange for a volunteer to deliver your shopping to you. 

Tips for picking up your prescriptions

Pharmacies are working hard to make sure that everyone with diabetes gets the medicines they need. Help them to help you by following these tips:

  • Follow government advice and don't go to a pharmacy if you or anyone in your household has a temperature or a new and continuous cough, even if mild. Some organisations like Boots pharmacy have an online service and are encouraging customers to choose for their medicines to be delivered to their homes – you don't have to sign for these now, the delivery driver will leave the package somewhere safe and let you know.
  • Plan ahead where possible. Our advice is to try and order your next prescription at least 14 days before it is due. 
  • Put your contact details on prescriptions so pharmacies can let you know when your medicines are ready, so you won’t need to be in the pharmacy for as long. Please don’t ring the pharmacy unless it’s urgent.
  • If you're self-isolating, see if family, friends or neighbours can pick up your medication for you. If you don’t have anyone who can collect your medicine, speak to your community pharmacy for advice about how they can help. There might be community or voluntary groups ready to help in your area.
  • If you're well and can visit the pharmacy yourself, think about how you can help family, friends and neighbours who are self-isolating by collecting their medicines on their behalf (you may need to take ID with you and will need to know the name and address of the person you are collecting for).
  • Don't ask for extra medicine. Continue to get medicines as normal and don't stockpile.
  • Ask your prescriber about electronic repeat dispensing, so you can order your repeat prescriptions online.

Where can I get more support?

We know some people may not have friends and family able to help while they are isolated at home. You may be able to get help from voluntary groups in your area or your local councils or local authorities. Check your government websites for more information.

You could also find out if there's a diabetes local group in your area. Use our postcode search.

Need to talk?

You might be feeling worried and anxious about coronavirus and how it might affect you or your family and friends. We know this could be a stressful time, so you may need support with how you’re feeling. 

We have some helpful information to help you cope with stress and other emotions, or you might like to call our helpline to talk it through with someone. We also have a useful coronavirus thread on our online forum, where members are sharing information and experiences so you might find answers to any more questions.

We recently arranged for Devanshi, who is living with type 1 diabetes and living in Leicester, to meet Anna who works on our helpline. Did you know that you don't need a question about diabetes to call us? Find out what Anna and Devanshi chatted out.

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