by Betsy Rodríguez, BSN, MSN, CDCES
The global threat of COVID-19 is looming large every day, with news of additional cases and deaths, travel advisories and potential economic fallout. The media keeps reporting that people with “underlying medical conditions” are at particularly high risk for severe illness from COVID-19 — and diabetes is at the top of the list. Everyone is at risk for getting COVID-19 if they are exposed to the virus. Some people are more likely than others to become severely ill, which means that they may require hospitalization, intensive care, or a ventilator to help them breathe, or they may even die. So, should people with diabetes be especially concerned? And what can we, as healthcare professionals, do to help them stay safe?
People with diabetes whose blood sugar levels are often higher than their target are more likely to have diabetes-related health problems. Those health problems can increase the risk of severe illness from COVID-19.
In general, people of any age with type 2 diabetes are at increased risk of severe illness from COVID-19. Also, children who are medically complex or metabolic conditions like diabetes, are at higher risk for severe illness from COVID-19 than other children. Based on what we know at this time, having type 1 or gestational diabetes may increase your risk of severe illness from COVID-19.
According to the Centers for Disease Control and Prevention (CDC), people with diabetes whose blood sugar levels are often higher than their target are more likely to have diabetes-related health problems
. Those health problems can increase the risk of severe illness from COVID-19.
It’s important for people with diabetes to follow the guidance of CDC if planning to travel
and to review diabetes sick day protocols
in case they do get infected. Staying home is the best way to stay safe and to protect others from getting sick, but if individuals with diabetes decide to travel, there are a few things you can do to help them prepare.
Ask them the following questions to help make an informed decision about traveling:
- Is COVID-19 spreading where you’re going? Tell them that they can get infected while traveling. Remind them that, even if they don’t have symptoms, they can spread COVID-19 to others while traveling.
- Will you or those you are traveling with be within 6 feet of others during or after your trip? Being within 6 feet of others increases your chances of getting infected and infecting others.
- Are you or those traveling with you more likely to get very ill from COVID-19?
- Does the state or local government where you live or at your destination require you to stay home for 14 days after traveling?
- If you get sick with COVID-19, will you have to miss work or school? People with COVID-19 will have to stay 100% at home and if they get sick from COVID-19, they will need to stay until they are no longer considered infectious. Guide them to think about the implications for their work, school and their family and loved ones.
- During their trip, tell them to protect themselves and others by doing the following:
- Clean hands often.
- Avoid touching the eyes, nose or mouth.
- Avoid close contact with others and keep 6 feet of physical distance from others, even when you wear a face covering.
- Avoid mass gatherings that involve a large number of people. Huge crowds can come with unique risks to travelers including increasing the spread of infectious diseases. Wear a cloth face covering in public, if appropriate.2 Cloth face coverings should not be worn by children under the age of 2 years, anyone with trouble breathing, or anyone who cannot remove the face covering without assistance.
- Cover coughs and sneezes. Cover your mouth and nose with a tissue when coughing or sneezing. Throw away used tissues in a lined trash can. Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol.
- Explain to them that it is hard to know if one type of travel is safer than others; however, airports, cruises, bus stations, train stations and rest stops are all places travelers can be exposed to the virus in the air and on surfaces. These are also places where it can be hard to social distance.
- Explain to them that it would be better if they avoid cruises, because of the unprecedented nature of the novel coronavirus pandemic, and the increased risk of transmission of COVID-19 on cruise ships, the US government is advising US travelers to defer all cruise travel.
- Tell them that the CDC recommends everyone stay home as much as possible, especially if the trip is not essential, and to practice social distancing.
- Finally, share with them where they can find out about travel restrictions in different states and countries. If they decide to travel, check with the state or local authorities where they are, along their route, and at their planned destination to learn about local circumstances and any restrictions that may be in place.
For more information on traveling during the COVID-19 pandemic, visit the CDC COVID 19 website
. For additional tools and resources on COVID-19 for diabetes care and education specialists, visit DiabetesEducator.org/COVID-19
About the Author
Betsy Rodríguez BSN, MSN, DCES
Senior Public Health Advisor
Division of Diabetes Translation
Center for Disease Control and Prevention
Betsy Rodríguez is a nurse, diabetes educator, national and international speaker and trainer on diabetes-related topics, bicultural specialist in health communication strategies, and author. She serves as a Senior Public Health Advisor in the Translation and Health Education and Evaluation Plan in the Division of Diabetes Translation (DDT) at the Centers for Disease Control and Prevention (CDC). She is also a member of the ADCES Favorably Review Group and a member of the ADCES 2021 Planning Committee.