Management of Long Term Conditions During COVID-19
Information for people with Type 2 Diabetes
We are keen to support you during the Covid-19 pandemic and prevent diabetes related admissions to hospital. You should follow up to date government advice with regards isolation and attendance for testing.
Having type 2 diabetes puts you in a high-risk group so the advice is to significantly limit face-to-face interaction with friends and family if possible. The expert advice from Diabetes UK advice on Covid-19 can be found at: https://www.diabetes.org.uk/about_us/news/coronavirus Please ensure that you have adequate supplies of medication and testing strips if you check your blood glucose, to cope during either self-isolation or illness. The Trend guide is excellent on what to do if you have type 2 diabetes and are unwell: https://trend-uk.org/wp-content/uploads/2018/12/A5_T2Illness_TREND.pdf
Some patients may be at risk of developing a serious condition called diabetes ketoacidosis. This is rare in Type 2 diabetes but it is more likely to occur if you take a medication called an SGLT2 inhibitor such as Empagliflozin or Canagliflozin. If you take one of these medications, you can get information as to how to keep your diabetes stable and the signs of ketoacidosis at: http://trend-uk.org/wp-content/uploads/2017/02/TREND-DKA-4pp-patient-leaflet-spreads_screen.pdf If you are unwell with a fever, please stop the SGLT2 inhibitor tablet, continue your other medication and contact your GP or NHS 111 immediately as you will need to get your blood checked for ketones. Your GP/ NHS 111 can phone the hospital team for advice if needed.
Metformin is best stopped if you are unwell and not able to eat and drink properly. Recent media reports that ACE Inhibitor drugs (‘pril’ drugs) and Angiotensin receptor blockers (‘sartan’ drugs) may increase the risk of death from novel corona virus (COVID-19) infection will provoke anxiety for many people with diabetes and leave them uncertain about the best action to take. People are prescribed these medications for a number of reasons and for some people, particularly those with heart failure, stopping the drugs suddenly can lead them to become unwell. This can cause people to become more breathless and may create uncertainty about whether symptoms are due to infection (such as COVID-19), or to underlying health problems. The evidence that these medications increase the risk of death is unconvincing: the reports may simply reflect the fact that people taking the drugs are more likely to have conditions that place them at high risk of severe COVID-19 infection. We therefore advise people taking these medications to continue to take them. If they become unwell such that they need to seek medical help, the doctor may advise stopping the drugs depending on their clinical condition.
Please be aware that most diabetes appointments at the hospital or with your GP practice will be changed into a telephone call to reduce your risk of catching infection. Some appointments may be postponed due to current pressures on the NHS. You will be contacted about your appointment in due course.