When should a person with diabetes go to the hospital due to COVID? 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Bell, MD, FACP — By MaryAnn De Pietro, CRT on August 26, 2022COVID-19 is a disease that can lead to serious complications. Living with diabetes may increase a person’s risk of severe disease. It is vital for people with this condition to know how to manage their health and when to seek medical attention after acquiring the virus. COVID-19 is a disease that results from an infection with the virus SARS-CoV-2. Diabetes refers to a group of conditions that affect how the body processes blood glucose. People living with diabetes may have an increased risk of serious COVID-19-related illness. As such, it is advisable for these individuals to get COVID-19 vaccines and maintain safety measures. Many people experience mild symptoms from COVID-19 and do not need to go to the hospital. However, if a person develops emergency warning signs, it is advisable to seek medical attention immediately. In this article, we discuss when a person living with diabetes should go to the hospital due to COVID-19. We also look at how to prevent and treat the condition. All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub for the most recent information on the COVID-19 pandemic. When should a person with diabetes go to the hospital Share on PinterestRichLegg/Getty ImagesAs the American Diabetes Association (ADA) states, a person with diabetes should go to the hospital if they begin to experience emergency warning signs for COVID-19. The Centers for Disease Control and Prevention (CDC) list the following warning signs:trouble breathingpain in the chestinability to stay awakenew confusionblue, gray, or pale skin, lips, and nail beds Having diabetes may increase a person’s risk of developing severe symptoms and complications. According to the American Heart Association (AHA), someone with a COVID-19 diagnosis should do their best to maintain stable blood glucose levels to avoid hyperglycemia and diabetic ketoacidosis (DKA). Research notes that experiencing hyperglycemia and DKA with COVID-19 may increase the risk of complications, contribute to unfavorable outcomes, and make hospital admission necessary. How does COVID-19 affect people living with diabetes According to the ADA, people with diabetes have an increased risk of developing serious complications from a COVID-19 infection. Research notes that these can include a higher risk of severe pneumonia and hospitalization. Furthermore, evidence notes that each of these conditions can negatively affect the other. A 2020 analysis indicates that people with type 1 and type 2 diabetes have three times the risk of complications as those without diabetes. For example, in a 2020 study, 22.2% of people in the intensive care unit had diabetes compared with 10.1% of the overall population hospitalized with COVID-19. In general, people with diabetes are more likely to experience complications from viral infections. This is particularly true if they are experiencing complications from their diabetes. Although more research is still necessary to confirm exactly why diabetes increases the risk of COVID-19 complications, evidence suggests that it may relate to the high levels of inflammation that a person may experience. In addition to altering the inflammatory response, some evidence suggests that diabetes may affect the entry of SARS-CoV-2 viral particles into cells. Furthermore, people with diabetes face a higher risk of DKA when they have a viral infection. A 2022 review notes that COVID-19 increases the risk of DKA, which, in turn, leads to less positive COVID-19-related outcomes. A 2021 case report makes a similar conclusion. Treating COVID-19 Anyone with COVID-19 should consult a doctor to determine the best treatment option. The treatment for COVID-19 may depend on a person’s risk of severe disease. As individuals with diabetes have an increased risk of complications, doctors may advise specific treatments. The CDC recommends that people with diabetes take certain steps if they become ill. These include:continuing to take insulin and diabetes medication according to the prescriptiontesting blood sugar every 4 hourseating normallydrinking extra calorie-free liquidschecking weight daily, as weight loss without trying may indicate high blood sugarchecking body temperature in the morning and evening It is also important to have enough medication, such as insulin, and easy-to-make foods on hand to last for a few weeks. A person may need to isolate at home and separate themselves from others as much as possible. The National Institutes of Health (NIH) also provide guidelines for managing COVID-19 at home, which include the use of medication. The Food and Drug Administration (FDA) has approved the use of two oral antiviral medications for treating mild to moderate COVID-19 and reducing the risk of severe disease. These are called nirmatrelvir/ritonavir (Paxlovid) and molnupiravir (Lagevrio). Prevention Certain safety measures may help reduce the risk of contracting SARS-CoV-2 and developing COVID-19. The World Health Organization (WHO) states that receiving a COVID-19 vaccination is the primary way for people to protect themselves. The WHO also recommends:washing the hands frequently with soap and wateravoiding crowdswearing a properly fitted mask in poorly ventilated indoor settings The CDC adds that further precautions may include:avoiding contact with people who are sicktaking a SARS-CoV-2 test after a known exposurestaying home if sick or after a positive COVID-19 test If a person tests positive for COVID-19, taking certain precautions may help prevent complications. These can include:talking with a healthcare professional about how to manage COVID-19checking blood sugar oftenmaintaining hydrationcontinuing to take diabetes medications Summary A person living with diabetes has an increased risk of experiencing severe complications of COVID-19. It is advisable to seek immediate medical attention if COVID-19 warning signs appear, such as trouble breathing, pain in the chest, and confusion. Additionally, it may be advisable for someone to consult a healthcare professional if they are finding it difficult to control their blood sugars. To help manage the condition, it is advisable to regularly check blood sugars and continue taking prescribed medications. A person can also take precautions to avoid COVID-19, such as receiving their vaccines, washing the hands regularly, and wearing a face mask where appropriate. Last medically reviewed on August 26, 2022DiabetesBlood / HematologyEmergency MedicineInfectious Diseases / Bacteria / VirusesCOVID-19 19 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Advice for the public: Coronavirus disease (COVID-19). (2022). https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-publicBeshbishy, A. M., et al. (2021). Factors behind the higher COVID-19 risk in diabetes: A critical review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8292635/Dey, R. K., et al. (2021). COVID-19 and emergencies in patients with diabetes: Two case reports. https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-020-02659-4Diabetes and COVID-19: Frequently asked questions. (n.d). https://diabetes.org/coronavirus-covid-19/covid-19-faqGregory, J. M., et al. (2020). COVID-19 severity is tripled in the diabetes community: A prospective analysis of the pandemic's impact in type 1 and type 2 diabetes. https://diabetesjournals.org/care/article/44/2/526/35515/COVID-19-Severity-Is-Tripled-in-the-DiabetesHow COVID-19 impacts people with diabetes. (n.d.). https://diabetes.org/coronavirus-covid-19/how-coronavirus-impacts-people-with-diabetesKnow your treatment options for COVID-19. (2022). https://www.fda.gov/consumers/consumer-updates/know-your-treatment-options-covid-19Landstra, C. P., et al. (2021). COVID-19 and diabetes: understanding the interrelationship and risks for a severe course. https://www.frontiersin.org/articles/10.3389/fendo.2021.649525/fullManaging sick days. (2022). https://www.cdc.gov/diabetes/managing/flu-sick-days.htmlMassetti, G. M., et al. (2022). Summary of guidance for minimizing the impact of COVID-19 on individual persons, communities, and health care systems - United States, August 2022. https://www.cdc.gov/mmwr/volumes/71/wr/mm7133e1.htm?s_cid=mm7133e1_xOliveira de Sá-Ferreira, C., et al. (2021). Diabetic ketoacidosis and COVID-19: What have we learned so far? https://journals.physiology.org/doi/full/10.1152/ajpendo.00244.2021Peric, S., et al. (2020). Diabetes and COVID-19. https://link.springer.com/article/10.1007/s00508-020-01672-3Singh, A. K., et al. (2020). Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195120/Table 2a. Therapeutic management of nonhospitalized adults with COVID-19. (2022). https://www.covid19treatmentguidelines.nih.gov/tables/management-of-nonhospitalized-adults-summary/Tzeravini, E., et al. (2022). The role of diabetes and hyperglycemia on COVID-19 infection course - a narrative review. https://www.frontiersin.org/articles/10.3389/fcdhc.2022.812134/fullVasbinder, A., et al. (2022). Inflammation, hyperglycemia, and adverse outcomes in individuals with diabetes mellitus hospitalized for COVID-19. https://diabetesjournals.org/care/article/45/3/692/140930/Inflammation-Hyperglycemia-and-Adverse-Outcomes-inVellanki, P., et al. (2021). Diabetic ketoacidosis risk during the COVID-19 pandemic. https://www.thelancet.com/journals/landia/article/PIIS2213-8587(21)00241-2/fulltextWhat people with diabetes need to know about COVID-19. (2020). https://www.heart.org/en/coronavirus/coronavirus-covid-19-resources/what-people-with-diabetes-need-to-know-about-covid-19What to do if you are sick. (2022).https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.htmlFEEDBACK:Medically reviewed by Angela M. 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