Diabetes increases risk for COVID-19 complications


More than 34 million Americans have diabetes. There is no data to suggest people with diabetes are more likely to get COVID-19. But there is evidence that type 2 diabetes increases the risk of severe illness from COVID-19. And it appears that having type 1 or gestational diabetes may also increase your risk for severe infection.

If you have diabetes plus another health condition, such as heart disease, your risk of COVID-19 complications grows even more. Your body has to work overtime to compensate for diabetes and another condition while also fighting a viral infection.

The connection between diabetes and COVID-19

You’re more at risk for severe illness from COVID-19 if you have diabetes because:

  • Your diabetes-compromised immune system makes your body work harder to fight off infection due to fluctuating blood glucose levels and possible diabetes complications.
  • Studies show an apparent link between high blood glucose levels and the severity of COVID-19 symptoms in patients with diabetes.

If someone with diabetes becomes sick with a viral infection, they are also more likely to develop diabetic ketoacidosis (DKA). DKA occurs when the body doesn’t have enough insulin to use its usual energy source — glucose. Instead, the body burns fat for energy, producing ketones. A buildup of ketones makes the blood more acidic. High ketone levels can be poisonous to the body.

Viral infections put people with diabetes at higher risk for DKA because managing fluid intake and electrolyte levels can be challenging when you’re sick. When dehydration or electrolyte imbalance occurs, you could be more vulnerable to a life-threatening condition known as sepsis, sometimes called septic shock. Sepsis occurs when bloodstream chemicals intended to fight infection instead trigger inflammation, leading to organ system damage.

COVID-19 and new-onset diabetes

In addition to worsening existing diabetes, researchers suspect COVID-19 could trigger the development of type 1 diabetes in people who don’t already have it. Doctors hypothesize that COVID-19 could damage cells found in the pancreas. This cellular destruction impacts pancreatic function, making it harder for the pancreas to make insulin.

Research continues, but the risk of new-onset diabetes from COVID-19 may be higher in people with a family history of diabetes or who have prediabetes themselves. So people with these risk factors should also take extra cautions to avoid coming in contact with the coronavirus.

Steps to protect yourself and reduce risk of COVID-19 complications

Protecting yourself starts with everyday risk-reduction strategies, including:

  • Face coverings: Masks also protect you from inhaling and exhaling coronavirus-containing respiratory droplets.
  • Handwashing: Use soap and water for 20 seconds, or a hand sanitizer with at least 60% alcohol content.
  • Physical distancing: Try to always maintain 6 feet of space between yourself and others. If the coronavirus spread is great in your community, consider outings for essential needs only.
  • Vaccination: Getting a flu shot protects you from the influenza virus, which will be circulating at the same time as the coronavirus.

The U.S. Centers for Disease Control and Prevention also recommend these actions for people with diabetes:

  • Take your diabetes medications as directed. Keep a 30-day supply on hand at all times.
  • Monitor your blood sugar and ketone levels.
  • Contact your provider immediately if you have a fever, breathing difficulties, nausea or other COVID-19 symptoms.
  • Have supplies at the ready, including calorie-free sports drinks, unsweetened apple sauce and instant cooked cereals.

If you have diabetes and are concerned about your risk of COVID-19 complications, contact your primary care physician.