Diabetes And Corona Virus

Here’s what you need to know:

People with diabetes are not more likely to get COVID-19 than the general population.

The problem people with diabetes face is primarily a problem of worse outcomes, not greater chance of contracting the virus. In China, where most cases have occurred so far, people with diabetes had much higher rates of serious complications and death than people without diabetes—and generally we believe that the more health conditions someone has (for example, diabetes and heart disease), the higher their chance of getting serious complications from COVID-19. We expect the death rate to decline over time as we get better at detecting and treating this specific virus.

People with diabetes do face a higher chance of experiencing serious complications from COVID-19.

In general, people with diabetes are more likely to experience severe symptoms and complications when infected with a virus.If diabetes is well-managed, the risk of getting severely sick from COVID-19 is about the same as the general population.

When people with diabetes do not manage their diabetes well and experience fluctuating blood sugars, they are generally at risk for a number of diabetes-related complications. Having heart disease or other complications in addition to diabetes could worsen the chance of getting seriously ill from COVID-19, like other viral infections, because your body’s ability to fight off an infection is compromised.

Viral infections can also increase inflammation, or internal swelling, in people with diabetes. This is also caused by above-target blood sugars, and both could contribute to more severe complications.

When sick with a viral infection, people with diabetes do face an increased risk of DKA (diabetic ketoacidosis), commonly experienced by people with type 1 diabetes. DKA can make it challenging to manage your fluid intake and electrolyte levels—which is important in managing sepsis. Sepsis and septic shock are some of the more serious complications that some people with COVID-19 have experienced.

COVID-19 is different from the seasonal flu.

COVID-19 is proving to be a more serious illness than seasonal flu in everyone, including people with diabetes. All of the standard precautions to avoid infection that have been widely reported are even more important when dealing with this virus.

Recommended safety precautions are the same as for flu, such as frequent hand washing and covering coughs and sneezes with a tissue or your elbow. The CDC does not recommend the use of face masks by people who are not infected.

We encourage people with diabetes to follow the guidance of the CDC and to review how you manage sick days—preparing for a sick day can make it easier.

The risks are similar for people with type 1 and type 2 diabetes.

In general, we don’t know of any reason to think COVID-19 will pose a difference in risk between type 1 and type 2 diabetes. More important is that people with either type of diabetes vary in their age, complications and how well they have been managing their diabetes.

People who already have diabetes-related health problems are likely to have worse outcomes if they contract COVID-19 than people with diabetes who are otherwise healthy, whichever type of diabetes they have.

Manufacturers are not reporting that COVID-19 is impacting access to insulin and other supplies.

Leading manufacturers are reporting that COVID-19 is not having an impact on their current manufacturing and distribution capabilities for insulin and other supplies at this time. We are continuing to monitor the situation and will provide updates should anything change. If you are struggling to pay for insulin or know someone who is, the ADA has resources to help—visit InsulinHelp.org.

If COVID-19 is spreading in your community, take extra measures to put distance between yourself and other people to further reduce your risk of being exposed to this new virus. Stay home as much as possible.

Before you get sick, make a plan:

Gather your supplies:

  • Phone numbers of your doctors and healthcare team, your pharmacy and your insurance provider
  • List of medications and doses (including vitamins and supplements)
  • Simple carbs like regular soda, honey, jam, Jell-O, hard candies or popsicles to help keep your blood sugar up if you are at risk for lows and too ill to eat
  • If a state of emergency is declared, get extra refills on your prescriptions so you do not have to leave the house
    • If you can’t get to the pharmacy, find out about having your medications delivered
  • Always have enough insulin for the week ahead, in case you get sick or cannot refill
    • If you are struggling to pay for insulin or know someone who is, the ADA has resources to help—visit InsulinHelp.org
  • Extra supplies like rubbing alcohol and soap to wash your hands
  • Glucagon and ketone strips, in case of lows and highs
  • Have enough household items and groceries on hand so that you will be prepared to stay at home for a period of time

Talk to your health care team about the following:

  • When to call your doctor’s office (for ketones, changes in food intake, medication adjustments, etc.)
  • How often to check your blood sugar
  • When to check for ketones
  • Medications you should use for colds, flu, virus, and infections
  • Any changes to your diabetes medications when you are sick

Take everyday precautions:

  • Avoid close contact with people who are sick
  • Take preventive actions:
    • Clean your hands often
    • Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
    • If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
    • To the extent possible, avoid touching high-touch surfaces in public places–elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
    • Wash your hands after touching surfaces in public places.
    • Avoid touching your face, nose, eyes, etc.
    • Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)
    • Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
    • Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.

Watch for emergency warning signs:

If you develop emergency warning signs for COVID-19 get medical attention immediately. In adults, emergency warning signs include:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

If you feel like you are developing symptoms, call your doctor:

Pay attention for potential COVID-19 symptoms including fever, dry cough and shortness of breath. If you feel like you are developing symptoms, call your doctor.

When you call:

  • Have your glucose reading available
  • Have your ketone reading available
  • Keep track of your fluid consumption (you can use a 1-liter water bottle) and report
  • Be clear on your symptoms (for example: are you nauseated? Just a stuffy nose?)
  • Ask your questions on how to manage your diabetes

If you do get sick, know what to do:

Here are some common tips, which may vary for each person:

  • Drink lots of fluids. If you’re having trouble keeping water down, have small sips every 15 minutes or so throughout the day to avoid dehydration.
  • If you are experiencing a low (blood sugar below 70 mg/dl or your target range), eat 15 grams of simple carbs that are easy to digest like honey, jam, Jell-O, hard candy, popsicles, juice or regular soda, and re-check your blood sugar in 15 minutes to make sure your levels are rising. Check your blood sugar extra times throughout the day and night (generally, every 2-3 hours; if using a CGM, monitor frequently).
  • If your blood sugar has registered high (BG greater than 240mg/dl) more than 2 times in a row, check for ketones to avoid DKA.
  • Call your doctor’s office immediately, if you have medium or large ketones (and if instructed to with trace or small ketones).
  • Be aware that some CGM sensors (Dexcom G5, Medtronic Enlite, and Guardian) are impacted by Acetaminophen (Tylenol). Check with finger sticks to ensure accuracy.
  • Wash your hands and clean your injection/infusion and finger-stick sites with soap and water or rubbing alcohol.

Know your rights:

A reminder: If you have diabetes, you have legal rights that do not go away during a health crisis like COVID-19.

  • Even in a pandemic, you have the right to reasonable accommodations at work, which could include medical leave or alternate work arrangements.
  • Your child’s Section 504 Plan should include accommodation for extra sick days without penalty. This would apply if your child is sick or if you choose to keep him or her home from school to avoid contagion with COVID-19.
  • People with diabetes who are incarcerated or in police custody are entitled to appropriate and adequate medical care, and their medical needs may change during infectious disease outbreaks.

If you are concerned you are being treated unfairly because of your diabetes, contact us to seek help from our Legal Advocacy team.

For more information, please call 1-800-DIABETES (800-342-2383).Related pagesPlanning for Sick Days

Partner sites

American Diabetes Association


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Women’s Health Info

woman in her 40's sitting on the couch

Perimenopause Starts Around Age 40

Menopause is defined as the point when it’s been a full year since your last menstrual period. For women in the United States, this occurs around age 51. You may not realize that perimenopause starts as early as your late 30s, as changes in hormones begin to cause symptoms such as fatigue, brain fog and fuzzy thinking, and weight changes. You are also more likely to develop a thyroid condition as you age. This makes it confusing to tell if symptoms are due to perimenopause, thyroid disease, or both.

The Symptoms of Perimenopause/Menopause and Thyroid Are Almost Identical

Hypothyroidism can also cause amenorrhea (absence of menstrual cycles). It can be confusing to determine if your symptoms are due to perimenopause/menopause and/or thyroid disease because the signs and symptoms are almost identical.

Always Check Your Thyroid First!

If you have menopause and/or thyroid symptoms, your first step should be to ask for a comprehensive thyroid evaluation. Testing for thyroid disease — including a thyroid stimulating hormone (TSH), Free T4, Free T3, and antibody levels — can help detect an undiagnosed thyroid condition. According to the American Association of Clinical Endocrinologists, only 25 percent of women who discuss menopause with a doctor is also tested for thyroid disease. That means, it’s up to you to ask. Thyroid diseases may run in families.

If Your Periods Stop or Are Irregular, It May Be Thyroid … Not Menopause

An erratic menstrual cycle is common during perimenopause. And the most definitive sign that menopause is underway is that your menstrual periods stop. If your periods are irregular or have stopped, you and your doctor may assume that it’s related to perimenopause/menopause. Menstrual issues are, however, common symptoms of untreated thyroid conditions. Always ask for a complete thyroid evaluation to rule out your thyroid as a cause for any menstrual irregularities.

Thyroid Treatment May Resolve Your Perimenopausal/Menopausal Symptoms

In some cases, symptoms attributed to perimenopause/menopause may be partially or fully resolved when you get your thyroid condition properly diagnosed and optimally treated. If you are experiencing symptoms and are diagnosed with a thyroid problem, talk to your healthcare provider about the benefit of pursuing thyroid treatment before considering hormone replacement therapy (HRT) for menopause.

If HRT Isn’t Working, Check Your Thyroid

While hormone replacement therapy (HRT) is not used as extensively as it was in the past, women with debilitating menopausal symptoms are sometimes prescribed estrogen, progesterone, or combination HRT. If your HRT is not resolving your symptoms, however, this is an indicator that you should pursue a comprehensive thyroid evaluation.

Get Moving!

Regular exercise and physical activity can reduce inflammation, help improve your sleep and mood, and resolve many perimenopausal/menopausal symptoms. Don’t overdo it with debilitating workouts that raise stress hormones and cause burnout. My favorite program is the “Mindful Movement for Healthy Hormones and Menopause Management” DVD from exercise physiologist Teresa Tapp.

women meditating

Try a Mind-body Approach

If your symptoms aren’t relieved by traditional medical treatments, consider mindfulness practices, especially guided meditation. Research shows that guided meditation and mindfulness approaches such as meditation, yoga, and breathwork can help improve a variety of menopausal symptoms. My recommendation is Demo DiMartile’s guided meditation CD/MP3 audio, Hormonal Balance: Restoring Inner Peace & Power.

Melatonin is a Master Hormonal Conductor

You may think of melatonin as a sleep or jetlag remedy. But it’s a support for hormone function. For me, after years of erratic periods during perimenopause, supplementing with 3 mg of melatonin nightly regulated my cycle and relieving morning fatigue for years. While more studies need to be done on the effect that melatonin has on thyroid hormone levels, you can learn more about the hormonal power of melatonin—including improved T4-to-T3 conversion and elimination of morning depression in menopausal women—l report on the Reversal of Aging.

Maca powder.

Maca May Be a Helpful Natural Solution

For centuries, the root vegetable maca has been a natural remedy for menopausal symptoms — a use now supported by research. Maca doesn’t contain hormones; it helps your body balance estrogen, progesterone, and other hormones – including the thyroid – more effectively. This can relieve symptoms such as hot flashes and low sex drive. (Avoid improperly-prepared maca. If not heated, it can aggravate thyroid problems.) I recommend therapeutic-grade Royal Maca from Whole World Botanicals — one of my menopause go-to’s

doctor and female patient talking

See a Menopause Expert

Some endocrinologists have expertise in managing perimenopause/menopause, but many don’t. Similarly, some gynecologists have expertise in managing thyroid conditions, but many don’t. You may want to consult with Certified Menopause Practitioners (CMP) for additional guidance.


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Diabetic Care, Valentine’s Day

Happy Valentine’s Day! If you’re like most people, odds are your day will involve some (or a lot) of chocolate and sweets. However, if you’re diabetic or pre-diabetic, you have to be careful about your sugar intake today. In fact, Valentine’s Day is actually the day with the highest average blood glucose levels among people with diabetes.

The numbers were reported by the digital health tracking platform Glooko, a web and mobile application that tracks blood glucose levels among more than 1.5 million users across 23 different countries. After looking at the collective data of their users, researchers uncovered that Valentine’s Day was the worst day for users in terms of keeping their blood glucose levels in a healthy range. Here’s a look at the average blood glucose levels on some of the worst days in the calendar year:

  • Valentine’s Day – 168 mg/dL (9.3 mmol/L)
  • Halloween – 158 mg/dL (8.8 mmol/L)
  • Christmas Day – 140 mg/dL (7.8 mmol/L)
  • New Year’s Eve – 131 mg/dL (7.3 mmol/L)

Michelle de Haaff, Glooko’s vice president of Strategy, said Valentine’s Day is so problematic for diabetics because of the regular opportunities to snack on chocolate and because many people go out to eat for dinner.

“Valentine’s is known to be a sugary holiday where chocolates are given as gifts and people go out for meals. It is likely that is what drives higher glucose,” said de Haaff.

Diabetic Care on Valentine’s Day

So if you are diabetic or pre-diabetic, we want to share some tips for helping you navigate Valentine’s Day and other holidays. For starters, eat and drink in moderation. And by moderation, we don’t mean just one piece of chocolate every time you come into the break room. One or two pieces are fine with lunch or dinner, but don’t snack on these sugary sweets throughout the day. Other tips to help keep your blood glucose levels in check include:

  • Fill up on healthier options so you’re not tempted to overindulge with sweets.
  • Drinking plenty of water can help you feel full.
  • Try to carve out 30-45 minutes to exercise.
  • Limit your alcohol consumption during dinner.
  • Monitor your blood glucose levels throughout the day.

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Avoid An Early Death- Do These…

The five: exercises to help avoid an early death

Easy-to-access activities that help to reduce blood pressure, cholesterol and the risk of heart diseaseGregory RobinsonSun 10 Nov 2019 00.30 EST


Last week, research published by the British Journal of Sports Medicine found that running can reduce the risk of early death regardless of how long or at what speed you run. The research focused on 14 previous studies based on six different groups of participants, totalling more than 230,000 people over a period of between 5.5 and 35 years. The authors reported that any amount of running, even just once a week, is better than no running at all.


Swimmers were found to have a 28% lower risk of early death and a 41% lower risk of death as a result of stroke or heart disease, according to a 2017 study by Swim England. Over 80,000 people took part. The report also said swimming is a cost-effective, safe and viable exercise for people of all ages, it helps older people stay mentally and physically fit and can help children develop physical, cognitive and social skills through swimming lessons.


Scientists attempting to find the health benefits of different sports found that regular tennis and badminton sessions reduce the risk of death at any given age by 47%. The study, published by the British Journal of Sports Medicine, gathered responses from over 80,000 adults aged 30 and over, through surveys taken between 1994 and 2008.


In addition to improving strength, breathing and flexibility, yoga has been found to reduce risk factors for heart disease, such as high body mass index, cholesterol and blood pressure. A study by the American College of Cardiology found that people combining yoga practice and aerobic exercise, such as running or swimming, saw double the reduction in high BMI, cholesterol levels and blood pressure in comparison with people who were taking part in just one or the other exercise.

Brisk walking

Numerous studies have suggested that sitting for too long can be a risk factor for early death. A study published by the British Journal of Sports Medicine found that low-level activities, such as going for a walk for just 10 to 59 minutes per week, can lower the risk of death from any cause by 18%.Topics


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Damaging Your Lungs…without knowing it


Your lungs are one of your body’s most important organs. They deliver oxygen to the body while ridding it of carbon dioxide.


Smoking is one of the worst things you can do for your lungs. The numerous chemicals in cigarette smoke damage your bronchial tubes, lungs, and the cilia in your respiratory tract. Fortunately, quitting smoking can improve breathing almost immediately, usually after only 72 hours of being cigarette-free.

Breathing secondhand smoke

Living with a smoker is also harmful to your lungs. Composed of nearly 4,000 chemicals, secondhand smoke damages your respiratory system. In addition to increasing your risk of developing lung cancer, secondhand smoke can also cause asthma, bronchitis, and other respiratory illnesses.

To keep your lungs healthy, avoid contact with secondhand smoke and encourage the smokers around you to butt out for good.

Living with thirdhand smoke

You may not smoke, but did the previous occupants of your home indulge in the habit? Watch out for thirdhand smoke, especially if you have rugs in your house. Even though you may not smell it, thirdhand smoke can hang around in floors and walls for years and ultimately cause lung problems.

Before moving into a home that once belonged to a smoker, be sure to give it a thorough cleaning. The same goes for any furniture or clothes you may have acquired from a smoker.

Not exercising enough

Physical exercise doesn’t just help you stay in better shape—practicing a sport also increases your lung efficiency. As you exercise more frequently, your stronger muscles will need less oxygen, and you won’t become winded as quickly.

Exercising near a busy street or factory

Partaking in physical activity means taking in a larger amount of air. If the air you breathe is polluted, your lungs will absorb a larger amount of harmful chemicals. Stay away from factories, busy roads, and highways when you exercise. Try working out in green spaces instead.

Rarely dusting your home

Air containing too much dust can eventually harm your lungs and cause various respiratory tract infections. Prevent this by regularly cleaning your home. Dust your furniture, vacuum, and wash your floors and walls.

Frequently using a wood-burning fireplace

Warming up beside a wood-burning fireplace may be cozy on a winter day, but it can be hazardous to your lungs. Wood smoke contains numerous chemicals that irritate lungs and bronchial tubes and can put you a risk of developing several respiratory illnesses.

Reduce the harmful effects of wood smoke by always burning dry wood and keeping your fire small.

Not using the vent when showering

When you take a bath or shower, remember to turn on your ventilation fan. This simple habit minimizes the proliferation of mold. Usually appearing as small black spots, mold is harmful to the lungs, especially for people with asthma or allergies.

Renovating a home containing asbestos

Are you planning to renovate a home that contains asbestos? Leave it to the experts. Breathing in asbestos fibers, even a small amount, is particularly dangerous to the lungs. You risk developing a chronic pulmonary illness that may not appear until years later.

Never testing your home for radon

Are you familiar with radon? This radioactive gas is the second most common cause of lung cancer in Canada. Invisible and odorless, radon usually enters homes through cracks, pipes, and windows. The only way to know if your home has radon is to purchase a radon test (they are usually quite affordable).

If you find that your home has too much radon, hire a specialist to correct the problem.

Never going to the doctor

If you can’t remember the last time you saw your doctor, it’s probably time to make an appointment. Depending on your age and history, your doctor may have you undergo a few exams and screening tests to ensure that your lungs are healthy.

Don’t wait until you experience symptoms before seeing your doctor. Some respiratory illnesses are asymptomatic at first and early detection can save you lots of heartache later on.

Never cleaning your gas stove

In addition to increasing its lifespan, regularly maintaining your gas stove minimizes your risk of nitrogen dioxide (NO2) poisoning. NO2 inflames respiratory passages and increases the risk of hospitalization due to pulmonary illness. If you don’t know how to clean your appliance, ask a professional for help.

14/21 SLIDES © Shutterstock

Cooking without using an exhaust hood

No matter what kind of stove you have, fine particles are released into the air each time you cook. These pollutants irritate the lungs, which can lead to respiratory problems and asthma attacks. To purify the air in your home when you cook, use an exhaust hood with an exterior vent.

Never cleaning your humidifier

Humidifiers can be quite useful, especially in homes with dry air. To truly benefit from this device, however, it must be cleaned regularly.

If you rarely clean your humidifier, it may end up emitting bacteria and mold into the air. You’ll feel the effect of these irritants in your lungs first and, over time, you may develop a pulmonary illness.

Not drinking enough water

The human body is made mostly of water so it’s important to drink enough H2O to stay hydrated. If you don’t drink enough water, your organs, especially your lungs, will suffer.

In fact, insufficiently hydrated people develop thicker-than-average mucus. Breathing becomes more difficult, and the risk of respiratory problems increases.

Not washing your hands often enough

Did you know that 80 percent of the most common respiratory infections are spread by touch? To protect your lungs from such infections, wash your hands frequently.

You should, for example, wash your hands before and after eating. If you have a cold, you should wash your hands after blowing your nose or sneezing.

Using chemical paint

Wall paint that’s high in volatile organic compounds (VOC) can irritate the lungs. To minimize health risks, choose a natural paint that contains the fewest VOCs possible.

If you regularly work with high-VOC paint, wear appropriate protective equipment and make sure your workplace is well ventilated.

Keeping your windows closed

While keeping your windows closed shuts out noise, this practice may also be bad for your lungs, especially if your home does not have a central ventilation system. Opening your windows ventilates your home by expelling noxious air and lowers the risk of mold development by reducing humidity.

Using air purifiers

Using an air purifier certainly helps your home smell better, but your lungs may not benefit as much. These devices usually contain VOCs that impair respiratory passages. Even natural and unscented products aren’t risk-free. To purify the air in your home, open your windows. It’s easy and doesn’t cost a thing!

Using chemical housecleaning products

While cleaning products eliminate bacteria, they pose a danger to your lungs. In one study, researchers found that women who regularly used chemical agents to clean their homes experienced a decrease in lung capacity.

To reduce the effects of chemical products on your lungs, use natural or homemade cleaning products.

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