by Christine McDermott, MS, RDN, CDE, BC-ADM, CDN

The last month has been overwhelming, to say the least.  Uncertainty can be stressful and this stress can affect our health both physiologically and mentally. 

Perhaps we could try to view this pandemic as a break from our hectic lives and focus on our self-care, almost like a reset button.  First and foremost, we need to follow the guidelines the CDC has instituted to protect ourselves.

Persons with diabetes are not necessarily more likely to contract the COVID-19 virus as compared to the general population, however, if contracted they are at greater risk for complications associated with the virus.

Infections can elevate blood sugars even if you are eating less than you usually do.  Hormones are released to help fight the infection, which can raise blood sugars.

The following are guidelines for adults with diabetes who may become sick:

1. Keep taking your insulin or diabetes medications.  Your medications may need to be adjusted.  Contact your healthcare provider if you are unable to get your blood sugar below 300 mg/dl.
2. Check blood sugars every 2-3 hours. If you have a Continuous Glucose Monitor, watch your trends and make sure your correction dose of insulin is working.
3. If blood sugars are ≥240 mg/dl, check for ketones (if instructed by healthcare team).  If ketones are moderate to high, contact your healthcare provider.
4. Smaller, more frequent meals and liquids may be easier to tolerate.
5. If you are still unable to eat, be sure to consume plenty of non-caloric liquids, such as tea, broth and water to prevent dehydration.
6. If you are still unable to eat, be sure to consume plenty of non-caloric liquids, such as tea, broth and water to prevent dehydration.
7. If you are unable to eat, consume 15 grams of carbohydrate every 1-2 hours.

Examples of 15 grams of carbohydrate:

• ½ cup juice
• 1 cup regular Gatorade
• 1 slice toast
• ½ cup applesauce
• 6 saltines

If you are taking Canaglifozin, Dapaglifozin, Empaglifozin or Ertuglifozin, be sure to contact your healthcare provider as soon as you begin to feel sick.  The effects of these medications have been found to last few days.

Call healthcare provider if you:

• Are unable to get blood sugars below 300 mg/dl
• Have a Persistent fever
• Are Vomiting or have diarrhea for more than 4-6 hours
• Have Moderate-High ketones in urine

Be sure to have a thermometer, extra diabetes medications, blood glucose testing equipment, syringe and 2 vials of insulin as back up if you have an insulin pump, non-caloric fluids, fluids with calories and electrolytes and ketone test strips (if instructed by healthcare team) Also, consider having your medications delivered to your home.

East End Nutrition wishes you all the gift of health.

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Source: American Diabetes Association, Diabetes Pro: Planning for Sick Days for Your Patients During COVID-19.  Professional.diabetes.org, accessed April 15, 2020.