Unless you have been living under a rock, you have heard the news about the latest viral outbreak, COVID-19. For people with type 1 diabetes, there is a very real fear of coming down with any flu virus and COVID-19 is no different.
Those living with diabetes are more likely to develop serious flu complications such as pneumonia, bronchitis, sinus infections, and ear infections. High blood sugars can also be harder to control when you have the flu.
What the World Health Organization says about COvid-19
We believe it is important to be educated in order to make informed decisions that are best for you and your family. Here are some important things that we have learned from the World Health Organization website about COVID-19:
- If you are healthy, wear a mask if you are working with someone who is sick. If you are sick, wear a mask if coughing or sneezing to avoid infecting others.
- Always wash your hands before putting on a mask. Properly dispose of your mask after use.
- Proper handwashing is the best way to avoid transmission.
- Avoid touching your eyes, nose, and mouth.
- Studies suggest that coronaviruses (including preliminary information on the COVID-19 virus) may persist on surfaces for a few hours or up to several days. This may vary under different conditions (e.g. type of surface, temperature or humidity of the environment). It is advised that if you think a surface may be infected, clean it with simple disinfectant to kill the virus and protect yourself and others.
- This is a virus and cannot be treated with antibiotics. Antibiotics may be used if a bacterial co-infection develops.
- It is not transmitted through mosquitos and cannot be caught by your pet. While there has been mention of a dog getting the virus in Hong Kong, vets feel that the virus was probably on the dog’s fur, but it did not sicken the dog. “The dog never became clinically ill, and it remains unclear whether the dog tested positive from being kept in an environment with a COVID-19-infected human or if the dog truly became infected with COVID-19.” The 16-year-old dog has since passed away but the owner refused to allow medical staff to examine it for the cause of death. Either way, make sure to wash your hands after playing with your pets. You can read more about the corona virus and your dog on Fluent Woof.com
- Hand-dryers or UV disinfection lamps are not effective ways to sanitize your hands.
- It can take between 2-10 days for people who are infected to become sick with a fever.
- There is currently no vaccine.
- All ages are susceptible but older people and those with pre-existing conditions more prone to risk. It is advised that these individuals stay away from areas of infection outbreaks and practice proper handwashing.
what people with type 1 diabetes need to know about covid-19
For people with type 1 diabetes, there is a great fear and concern about coming down with the flu and COVID-19. The Juvenile Diabetes Research Foundation has stated that “people with T1D are not more susceptible to coming down with COVID-19. That being said, people with T1D who also have compromised immune systems (such as those with renal failure) should be diligent about taking measures to reduce risk.”
It is vital however that you prepare for the worst and hope for the best. That is why we are sharing the below advice from the Children With Diabetes Chairman of the Board, Dr. Kenneth Moritsugu, MD, MPH, FACPM, former Surgeon General of the United States.
- Make sure you have a diabetes emergency kit prepared, including a 90 day supply of medications if at all possible (contact your doctor regarding prescriptions, to see if they can help you obtain a 90 day supply). We understand that many pharmacies are restricting individual access to 90 day supplies of insulin or other supplies in an effort to prevent hoarding. Remind your pharmacy that during this stressful time, insulin needs are known to go up and many individuals will also need to check their bg levels more often.
- Review sick day rules.
- Keep low blood sugar treatment tools on hand.
- Update/obtain glucagon and ketone strips
what pharmaceutical companies are saying about diabetes supplies
Besides being concerned about getting COVID-19, people living with type 1 diabetes also have a very real fear of there being a shortage of supplies. Work stoppages and countries being shut down have left people with type 1 diabetes feeling insecure and vulnerable.
We reached out to the major pharmaceutical companies. Here are their most recent updates on continued access to diabetes supplies like insulin, pump supplies, and test strips.
- Eli Lilly (insulin manufacturer): Lilly does not anticipate shortages for any of our products, including all forms of insulin. They have offered options for people who have lost their jobs or insurance in the US. Please call them at (833)808-1234 to discuss your options.
- Novo Nordisk: Currently we are not experiencing any supply constraints. We are well prepared for situations like this and have an inventory policy that serves long-term supply.
- Sanofi: We are working to maintain the supply of all of our medicines and vaccines through close collaboration with our suppliers throughout the world. Our global network of manufacturing plants is operational and the diversity of our global sourcing helps ensure business continuity across all our product lines. At this time, Sanofi does not anticipate shortages for patients resulting from the COVID-19 situation.
- Medtronic: has stated in a letter to clients that to date, they are not experiencing any significant impact to their operations. They have robust business continuity plans to help ensure that support and delivery of their products to patients is not interrupted. They will continue to monitor this situation closely and will provide ongoing updates as needed.
- OmniPod: “Insulet continues to vigilantly monitor and manage the global impact of the Coronavirus outbreak. We do not anticipate any product supply issues at this time. We have planned for and built inventory and redundancy throughout our supply chain that is designed to mitigate against any supply shortages to our consumers. Our manufacturing facility in Shenzhen, China, currently is running and producing Omnipods. In addition, our automated manufacturing facility in the U.S. is providing redundancy, risk mitigation, and additional capacity. We also have a comprehensive plan in place to ensure the safety and well-being of our employees. We will continue to deliver our Omnipod system to those who depend on our products to manage their diabetes.”
- Tandem Diabetes Care: we do not anticipate a shortage of infusion sets, cartridges or other supplies at this time. Since the initial outbreak, our supply chain team has been in close communication with suppliers, particularly in regions more heavily impacted by COVID-19. As the global situation evolves, we’ll continue working to safeguard the reliable supply of our infusion sets and other items.
- YpsoMed: The mylife YpsoPump insulin pumps and mylife YpsoPump Reservoirs are manufactured in Switzerland and there is no supply issue. The mylife Orbit infusion sets are manufactured in Mexico and the production is running. Additionally, we have enough stock in our European warehouse.
- Dexcom: We have reviewed our supply chain in detail, and while we will continue to monitor it closely, at this moment there are no interruptions to Dexcom’s ability to produce and supply product as a result of the Coronavirus. Additionally, we continue to take every step to ensure every single one of our products that goes out the door meets the highest safety standards.
- Eversense will be stopping sales and marketing efforts to acquire new Eversense users in the US. No new patients or clinics will be initiated. Only people currently using Eversense and those whose sensor has shipped will be inserted, as insurance allows. In addition, the insertion and removal procedures will be required to be done by providers who are already certified.
- Abbott Freestyle: As of April 2, there has been no impact on the availability of FreeStyle Libre sensors in Canada. They are continuing to monitor the situation and are taking steps to protect product supply throughout their global manufacturing and distrubution network. They will keep their clients apprised as things evolve.
- Ascensia Diabetes Care: “We are working tirelessly to make sure Ascensia products are available when you need them. Product inventory is up to date and we have no concerns about the distribution process as of today. If we have any changes on the process they will be notified. To obtain more information please feel free to contact our customer service line 1-800-348-8100.
- Lifescan: While we are monitoring the COVID-19 situation, there is no present impact to our meter or strips supply and we have plans in place to mitigate any supply issues should the situation continue.
We are learning that some pharmaceutical associations and insurance companies are limiting access to diabetes supplies. This is not a reflection of any decrease in accessibility to supplies, it is something that they are choosing to do in an attempt to stop panic purchasing.
If you are struggling to pay for your insulin, read the options we have found for people living in the US and Canada.
social distancing, self-isolation, and quarantine with covid-19 means
We have all been told to practice social or physical distancing. Those who are returning to their home countries from abroad are being asked to self-isolate. We are also hearing of people who are quarantined but what does it all mean?
According to an article we found on NPR, social distancing means not shaking hands, avoiding crowds, and standing several feet from other people. You can also practice social distancing by avoiding crowds, especially in confined and poorly ventilated spaces. Do your grocery shopping at off-peak hours. Avoid using public transport during rush hours and exercise outdoors instead of indoor settings. Do not allow children to play in parks or on playground equipment.
In an attempt to help people further understand the concept of social distancing, the media and many government agencies have simplified the term to “physical distancing”. In other words, just staying away from other individuals.
Self-isolation or home isolation means remaining at home or in a designated setting, in a single, dedicated, adequately ventilated room and preferably using a dedicated toilet. You should not be leaving your home for a period of 14 days and monitoring yourself for symptoms of the COVID-19 virus.
Symptoms of COVID-19 include a fever of any grade, cough or difficulty breathing.
During self-isolation, ensure that you have access to your own washroom, or that it is cleaned thoroughly after you use it and before someone else does. Use a specific set of utensils, frequently wash bedding, and make sure that clothing is washed daily.
Quarantine has many similarities to self-isolation. If you are displaying signs of COVID-19, make sure to isolate yourself from other family members as well. Clean and disinfect your home, particularly frequently touched surfaces and toilettes. Use only one set of dedicated cutlery, plates, and glasses. Call ahead before visiting your doctor or local hospital. Make sure that you are wearing a mask if interacting with someone who does not have any symptoms.
If you do have COVID-19 and type 1 diabetes, make sure to follow your sick day protocol to stay safe.
If you are a Canadian, looking for virtual medical help this may be an option for you.
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things you can do if you have to self-isolate because of covid-19
Worldwide, many schools and workplaces are shutting down for an extended period of time. This can be stressful. It can also be a great time to catch up on things you have been putting off or simply make new memories with loved ones.
If you should find yourself in having to self-isolate, here are a few things to make the time more enjoyable!
- Watch an old movie.
- Binge the next season of that show you wanted to watch.
- Listen to your favourite music and dance.
- Read that book you have been wanting to get to.
- Sing like no one is listening.
- Video conference with family and friends.
- Send that email to a friend that you haven’t talked to in a while.
- Get out your crayons and colour in that colouring book.
- Finish that craft project you bought the supplies for but never got around to finishing.
- Finish a jigsaw puzzle.
- Paint a picture.
- Create a lego house.
- Build a blanket fort with your children.
- Deep clean that room you have been planning to purge.
- Cook a new meal.
- Bake cookies.
- Plan your garden.
- Start a journal.
- Go through your photo albums and share memories with loved ones.
- Learn a new card game
- Play a board game
- Decorate your insulin pod
- Design your next diabetes tattoo
Read more information on how to manage your diabetes when sick.
Our ebooklet has tips for handling type 1 diabetes should you get COVID-19 or any other virus.
Going back to work during COVID-19
Some businesses are reopening and people living with diabetes are wondering if it is safe for them to work. That is something to discuss with your healthcare team. If you do feel that your system is compromised or you are living with someone who could be at risk by you going back to work, there are some options for you.
To assist an employee with diabetes to work with their employer on this important issue, Diabetes Canada has a letter available to help.
A reader also forwarded this link from StepsToJustice.ca
What it is like to have covid-19 with type 1 diabetes
Try as we might, some individuals living with type 1 diabetes have and will get COVID-19. Below are links to stories from people who have type 1 diabetes and have recovered.
- I Had COVID-19 and Type 1 Diabetes by Cynthia Katsingris
- T1D + COVID-19 POSITIVE — ONE NURSE’S STORY by Todd Boudreaux
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