Preventive measures against coronavirus disease (COVID-19) and type 1 diabetes

UPDATED ON APRIL 8th, 2020 AT 10:00

In order to prevent the spread of the coronavirus disease (COVID-19), strict quarantine measures have been put in place by the Quebec government for people who are contaminated or at risk of being contaminated. In addition, quarantine recommendations have been put in place for everyone and especially people with a chronic disease or over 70 years of age. It is important to know the measures that are to be taken and be prepared for them, especially if you live with type 1 diabetes.

Plan at least a 14-day supply of insulin and materials.

If you are affected by the coronavirus disease, you will be quarantined for at least 14 days. This means that you will only be able to leave your home in case of emergency. For example, you will not be able to go to the grocery store or to the pharmacy.

It is therefore recommended to have enough insulin, diabetes-related supplies (strips and lancets, sensors for continuous glucose monitoring, needles, catheter, etc.) and food (especially fast-absorbing sugars) for a minimum of 14 days at all times.

To date, no insulin or diabetic-related supply companies have reported that there is a risk of backorders. Stocking for longer than 14 days is not required and could even interfere with supply.

If you’re planning a trip:

The Government of Canada recommends that everyone avoids unnecessary travel. Moreover, several restrictions on travel abroad have been established by the Montreal Airport. However, if you decide to travel, you could be quarantined in the country you are visiting.

It is therefore essential to plan, in addition to the equipment required when travelling with type 1 diabetes, equipment to deal with this situation, for example:

Your usual insulin and other medications
Syringes and/or needles or supplies for your insulin pump (if applicable)
Glucometer, strips and needles for your lancing device and/or continuous glucose monitor (if applicable)
Alcohol swabs
Fast-absorbing sugars such as juice or glucose tablets and glucagon
Ketone test strips and ketone meter (if applicable)
Snacks like granola bars
Batteries or charger for your pump / glucometer / continuous glucose monitor (if applicable)

Also, remember to have up-to-date treatment prescriptions with you.

If you decide to cancel airline tickets, you may want to contact your doctor. He or she may be able to provide you with a medical certificate to possibly cancel your trip at no charge. At this stage, it is strongly recommended not to travel if you have a chronic disease such as type 1 diabetes. You may end up in quarantine, or otherwise stalled, and your circumstances will be difficult to predict.

Risks for people living with type 1 diabetes

There is currently a great deal of information circulating on the internet about the greater susceptibility to infection in type 1 diabetes. This risk is possible. We do know that there is a greater risk of infection when blood glucose levels are poorly managed (hyperglycemia).

In a more general way, people living with type 1 diabetes are not at an increased risk of COVID-19 infection. However, the complications of an infection can be significant. These complications can also occur in people with compromised health (heart, lung or kidney conditions) and in people 70 years of age and older.

In the event of infection, high blood glucose levels are associated with an increased risk of developing inflammation. It could increase the risk of pulmonary complications as well as those related to high blood glucose levels.

If this situation occurs, it is important to keep in mind that more insulin may be required. It is also recommended to hydrate yourself, to check your blood sugar levels regularly and to measure ketones if necessary. A blood ketone value greater than 1.5 mmol/L indicates a need for rapid insulin and hydration. If the value does not drop quickly, contact your medical team. Click HERE to access tools for ketone body management (in french).

Updating your ketone test strip prescription should be considered.

In summary, the recommendations for blood glucose and ketone monitoring are the same for coronavirus as for influenza virus.

Public health guidelines for the general population

Avoid close contact with anyone with a cough, sore throat and fever.
Whenever possible, avoid public transport and travel.
Stay home as much as possible. Only go out when necessary.
Avoid touching your face with your hands.
Follow barrier measures (keep a distance of 2 metres between you and other people, cough or sneeze into a tissue, wash your hands regularly using a hydro-alcoholic gel or soap and water).
Regularly clean your home and work environment with disinfectants.
In case of respiratory symptoms with fever, we recommend that you call 1 877 644-4545 promptly for proper referral. You can also complete the Government of Canada’s self-assessment tool.

Always call 1 877 644-4545 before going to the emergency room.

If you had scheduled an appointment with your medical team for a diabetes follow-up, contact them to find out if a remote meeting (teleconsultation) is possible.

We recommend that you remain attentive to public health guidelines.