American Diabetes Association. How Coronavirus impacts people with diabetes. 2020. (accessed 8 October 2020)

BMJ Best Practice. Coronavirus disease 2019 (COVID-19). 2020. (accessed 28 September 2020)

Bornstein SR, Rubino F, Khunti K Practical recommendations for the management of diabetes in patients with COVID-19. Lancet Diabetes Endocrinol. 2020; 8:(6)546-550

Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: A review of pathogenesis. Indian J Endocrinol Metab. 2012; 16:S27-S36

Chen H, Guo J, Wang C Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020; 395:(10226)809-15

Diabetes UK. Updates: Coronavirus and diabetes. 2020. (accessed 8 October 2020)

Down S. How to advise on sick day rules. Diabetes and Primary Care. 2018; 20:(1)15-16

Fralick M, Schneeweiss S, Frascerra S Risk of diabetic ketoacidosis after initiation of an SGLT-2 inhibitor. N Engl J Med. 2017; 376:(23)2300-2302

Fraser E. Long term respiratory complications of covid-19. BMJ. 2020; 370

Hillson R. Covid-19: diabetes and death. A call to action. Practical Diabetes. 2020; 37:(3)76-77

International Diabetes Federation. COVID-19 outbreak: guidance for people with diabetes. 2020. (accessed 8 October 2020)

Jordan RE, Adab P, Cheng KK. Covid-19: risk factors for severe disease and death. BMJ. 2020; 368

National Institute for Health and Care Excellence. Guidance summary, ES23. 14th April 2020. COVID-19 rapid evidence summary: acute use of non-steroidal anti-inflammatory drugs (NSAIDs) for people with or at risk of COVID-19. 2020. (accessed 8 October 2020)

NHS 111 online. Check your symptoms. 2020. (accessed 8 October 2020)

NHS. Coronavirus (COVID-19). 2020. (accessed 8 October 2020)

Peters AL, Buschur EO, Buse JB Euglycaemic diabetic ketoacidosis: a potential complication of treatment with sodium-glucose co-transporter-2 inhibitors. Diabetes Care. 2015; 38:1687-1693

Rosenstock J, Ferrannini E. Euglycaemic diabetic ketoacidosis: a predictable, detectable, and preventable safety concern with SGLT2 inhibitors. Diabetes Care. 2015; 38:1638-1642

Seewoodhary Oozageer R. Coronavirus and diabetes: an update. Practical Diabetes. 2020; 37:(2)41-42

Shaw K. The impact of diabetes on COVID-19 infection. Practical Diabetes. 2020; 7:(3)79-81

Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020; 20:(6)689-696

Wang D, Hu B, Hu C Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 323:(11)1061-1069

Wu JT, Leung K, Bushman M Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China. Nat Med. 2020; 26:(4)506-510

Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323:(13)1239-1242

Yang J, Zheng Y, Gou X Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020; 94:91-95

Managing diabetes during the COVID-19 pandemic

02 November 2020
7 min read
Volume 31 · Issue 11


People with diabetes are known to be more severely affected by COVID-19 than the general population. David Morris provides an overview of how to manage the illness in this group

The outbreak of a new viral infection in Wuhan, a city in Habei Province, China, became evident in December 2019. For most individuals who contract COVID-19 the disease is mild to moderate. Older people are disproportionately affected with serious disease, while children appear less likely to experience serious illness. A number of conditions are linked to increased severity of disease and poorer outcomes including both type 1 and type 2 diabetes. This article looks at why those with diabetes are at higher risk, and how to manage diabetes during the pandemic.

The outbreak of a new viral infection in Wuhan, a city in Habei Province, China, became evident in December 2019. The origin of the infection appeared to be a seafood market and it seems likely that the COVID-19 virus crossed from animals to humans. It was soon clear that serious lung disease and increased mortality were possible consequences of acquiring this infection. The disease proved highly contagious and quickly spread to cause a global pandemic, arriving in the UK in late January 2020 (Seewoodhary and Oozageer, 2020).

The virus responsible for the disease known as COVID-19 was identified as SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which belongs to the coronavirus group of viruses that commonly cause mild upper respiratory disease. Structurally the coronaviruses are composed of a single-strand of RNA surrounded by a lipid envelope that appears spherical under an electron microscope with a crown or ‘corona’ of spikes on the surface. Coronaviruses were also responsible for the epidemics of SARS-CoV in 2002 in China and MERS-CoV in 2012 in Saudi Arabia (BMJ Best Practice, 2020).

Register now to continue reading

Thank you for visiting Practice Nursing and reading some of our peer-reviewed resources for general practice nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • New content and clinical newsletter updates each month