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COVID-19 Infection In People With Diabetes

Written by Prof. Dr. Chan Siew Pheng (Consultant Endocrinologist at SJMC and Honorary Professor at Department of Medicine, UMMC)

COVID-19 has changed the way we live. Uncertainty surrounding this novel coronavirus may be especially unsettling for people with long term health conditions including diabetes.1,2 Professor Dr Chan Siew Pheng, a Consultant Endocrinologist from Subang Jaya Medical Centre and Honorary Professor at the Department of Medicine, University of Malaya Medical Centre shares what’s currently known about diabetes and the coronavirus, as well as how to prepare and cope.

What is different between COVID-19 and other infectious diseases?


This new virus is deadly – it kills.3,4


It is highly infectious – everyone is equally at risk of catching the infection.3,4


Some COVID-19 patients have mild or no symptoms (so are unrecognised), but remain infectious.5,6


Symptoms of COVID-19 are variable – some start with gastro-intestinal symptoms such as diarrhoea and vomiting, and only later, develop the typical COVID-19 cough and fever.5,6


This virus is highly unpredictable – some have mild illness while tragically some will die.5,6

Are people with Diabetes more likely to catch COVID-19?

No, people with diabetes are actually not at increased risk for catching COVID-19.  The virus does not have a homing sensor for people with diabetes. But, they are just as likely to catch the infection as anyone else. 7

What happens if a person with Diabetes has COVID-19?

Unfortunately, if someone with diabetes becomes infected, they are 2-3-times more likely to have severe COVID-19 pneumonia and other end-organ damage. Eventually with risk of dying from the illness. 1,2

Who are at the highest risk for severe COVID-19?

Apart from diabetes, those who are older (>60 years), with high blood pressure/hypertension, heart disease, and kidney problems have higher risks.1-3

For diabetes, the principle is that people with higher glucose levels are at greater risk for more serious infection. This is because high glucose levels can reduce our body’s ability to fight infections. 1-3

However, as stated, this virus is unpredictable. There have been patients with every known risk factor for a poor outcome do well and recover, while there have also been patients with fewer risk factors do worse than expected. 5,6

What to do if you are unwell?

The right thing to do, if you are unwell, would be to consult your regular Doctor.

During COVID-19, when social distancing is the way to flatten the curve of infections, this may require you to consult your Doctor via a phone call (telehealth/telemedicine). So, COVID-19 may drastically change the way Doctors manage their patients; especially those who have longstanding medical problems but are stable and well controlled.

So, if you have Diabetes, what should you do?


Prevent yourself from catching COVID-19: Wash your hands frequently, wear a face mask, stay at home.


Make sure you have adequate supply of medications and continue taking your medicine regularly.

Stay Safe, Keep Healthy

The facts are, we do not know where the virus may be and who is infectious, it could it be the person we are talking to, the door handle, the money we are handling, the handle of the trolley in the supermarket etc. So, stay away, isolate and consider everyone as a potential carrier. There is no need to put ourselves in a situation where we can get infected.

I encourage everyone, in particular, those with medical illnesses, like diabetes, hypertension, to take this opportunity to take extra good care of themselves; to learn to control their diabetes, blood pressure during this MCO when they are not distracted by going out to work and social activities.

Please be sure to take care of yourselves and your families.

AVOID getting ill. Prevention is the name of the Game!

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1 Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities and its effects in coronavirus disease 2019 patients: A systematic review and meta-analysis.  Int J Infect Dis. 2020;94:91‐95.

2 Guo W, Li M, Dong Y, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19 [published online ahead of print, 2020 Mar 31]. Diabetes Metab Res Rev. 2020;e3319.

3 Du RH, Liang LR, Yang CQ, et al. Predictors of Mortality for Patients with COVID-19 Pneumonia Caused by SARS-CoV-2: A Prospective Cohort Study. Eur Respir J. 2020;2000524.

4 Wu JT, Leung K, Leung GM. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Lancet. 2020;395(10225):689‐697.

5 Day Michael. Covid-19: four fifths of cases are symptomatic, China figures indicate. BMJ 2020; 369: m 1375

6 Mild COVID-19 often Appears with Only Gastro Symptoms: Study. Available from: https://www.webmd.com/lung/news/20200401/mild-covid-19-often-appears-with-only-gastro-symptoms-study#1 [accessed 6th may 2020]

7 American Diabetes Association. How COVID-19 Impact People with Diabetes. Available from: https://www.diabetes.org/coronavirus-covid-19/how-coronavirus-impacts-people-with-diabetes [accessed 6th may 2020]