6/10/2020
Diabetes and COVID-19: What You Need to Know

On June 4, the Naomi Berrie Diabetes Center at NewYork-Presbyterian/Columbia University Irving Medical Center presented an informative webinar for people with diabetes and their loved ones about the latest information on staying healthy during the COVID-19 crisis. Utpal Pajvani, MD, Associate Professor of Medicine in the Division of Endocrinology and a physician at the Naomi Berrie Diabetes Center, addressed the audience. 

Are people with diabetes more likely to get COVID-19?

There is no increase in the risk of contracting the virus, but studies have shown that people with diabetes have a greater risk of developing more serious disease if they do become infected. That risk is compounded by the presence of other risk factors for severe COVID-19, such as obesity, older age, and heart disease. A British study on diabetes and COVID-19 showed that people with diabetes have a higher risk of dying, but the overall risk is still low. Dr. Pajvani noted that the study found that improved blood glucose control reduced risk of dying, a finding that replicated data from the United States.  

He added that among the people with diabetes he sees on an outpatient basis who developed COVID-19, those who reached out to him mainly wanted guidance on how to manage their blood sugar, and none were hospitalized. Making sure you manage your blood sugar well is key. Blood sugar can fluctuate in the presence of any infection, including the common cold, so it's important to monitor it with regular checks of your blood glucose, take your diabetes medicine as prescribed, and reach out to your doctor for help if you experience blood sugar changes and need guidance on how to control it effectively. Doing so will reduce your risk of developing diabetic ketoacidosis — a serious problem that happens when the body does not have enough insulin circulating to use glucose for energy, and the blood becomes acidic.

If I get COVID-19 and I have diabetes, will my symptoms be different than someone without diabetes?

The symptoms of COVID-19 are the same for people with and without diabetes. However, if you have diabetes and you see a disruption in your blood sugar levels, it may be an early indicator that you might have an infection and is worth a call to your doctor. You can probably have a telemedicine visit about this. If you end up being hospitalized, advocate for yourself by asking for a consultation with an endocrinologist.

When will we have a vaccine or treatment?

We don't have the answer to this yet, but research is underway. Some medications have been shown to be useful to support patients with COVID-19 in the hospital, but they are not a cure. Dr. Pajvani said he is nearly 100 percent sure that there will be a vaccine within a reasonable timeframe. 

Virtually every scientist around the world is orienting his or her research to COVID-19, which is unprecedented. Even in Dr. Pajvani's lab, where he studies diabetes and fatty liver, he and his colleagues are studying a protein that is involved in both diabetes and COVID-19. Other Columbia researchers are exploring the use of continuous glucose monitoring in the care of hospitalized patients with COVID-19 and diabetes; why some people without diabetes who have COVID-19 develop ketoacidosis; and whether a particular class of anticancer drugs may have activity against COVID-19. With so many scientists working on this problem, we'll get answers sooner.

Is there anything I can do to boost my immune system?

First, your immunity is not compromised because you have diabetes. It's also important to note that no vitamin, supplement, or medication has been shown to boost immunity, and some (like high doses of vitamin D) can be toxic. A daily multivitamin is okay. The best things you can do are controlling your blood sugar, eating a healthy diet, getting regular physical activity, and getting adequate sleep. 

If I have antibodies, am I immune to COVID-19?

There's no evidence yet to show if having antibodies provides immunity forever, but most doctors believe that you're immune to the current strain of coronavirus for at least the next three to six months. In the meantime, still use a mask and take other precautions, even if you have antibodies. Dr. Pajvani also advises everyone to get the vaccine when it is available.

When will it be safe for us to see our families again?

This is a question that is not specific to people with diabetes and the answer is, we don't know yet. Much of it depends on the answers to these questions; Have you and the people you want to see all been quarantining? Will you be meeting indoors or outdoors? Is everyone willing to wear a mask? Reach out to your primary care doctor to have a conversation about your specific situation. It may be possible, for example, to have an outdoor socially distanced get-together where everyone is taking the proper precautions. In the end, the decision is yours and depends on balancing how much you value that particular interaction with your level of comfort with risk.

Is it safe to send my child to summer day camp?

This is also a personal decision. The risk of COVID-19 in children as well as the related pediatric inflammatory syndrome is extremely low, but there is a risk that they can transmit the virus to adults at home. You'll need to make an individual choice, taking into account what's best for your child's social development. It can be very hard for a child to be cooped up at home for three months in the summer, and some parents may not be able to work under those circumstances. Speak with your doctor to discuss your personal situation. 

The Naomi Berrie Diabetes Center is conducting telehealth visits to help patients manage their blood sugar. Learn more and make an appointment.

Dr. Utpal Pajvani is an endocrinologist with a focus in diabetes. His research focuses on the role of developmental pathways in the regulation of type 2 diabetes and the use of existing therapeutic agents in other scientific areas in novel applications to ameliorate obesity-induced insulin resistance. He received his M.D. and Ph.D. degrees from the Albert Einstein College of Medicine and completed his residency training in Internal Medicine and fellowship in Endocrinology, Diabetes & Metabolism at Columbia University.