Atlanta, GA—The American Diabetes Association (ADA) is alerting diabetes patients that they might be at a higher risk of experiencing complications from COVID-19, although they are not more likely to contract the infection than the general population.

What can pharmacists do to help reassure and prepare those patients, who make up as many as 10% of adults in the United States?

“In general, people with diabetes are more likely to experience severe symptoms and complications when infected with a virus,” the ADA advises. “If diabetes is well-managed, the risk of getting severely sick from COVID-19 is about the same as the general population.”

The group adds that viral infections can also increase inflammation in diabetes patients, especially those with above-target blood sugars. In addition, primarily type 1 diabetes patients are at an increased risk of diabetic ketoacidosis, which can make it challenging to manage fluid intake and electrolyte levels to fight off sepsis.

In a statement, the American Society of Clinical Endocrinologists (ASCE) emphasizes the importance of those patients continuing to take their medications.

Pharmacists can help make sure they get their prescriptions refilled and are prepared with medications and testing supplies. Some states provide the opportunity to purchase an additional 30-day supply of insulin and other diabetes medications when a state of emergency is declared, according to the ASCE.

The group’s My Diabetes Emergency Plan provides resources for pharmacists and other healthcare professionals, including a checklist with essential items that diabetes patients need to have readily available.

The good news, according to the ADA, is that manufacturers are not reporting that COVID-19 is impacting access to insulin and other supplies.

“Recent studies have shown that of those hospitalized for severe disease, 22.2% to 26.9% reported living with diabetes,” the ASCE writes in its statement. “Diabetes and high glucose levels are associated with increased complications, respiratory failure and mortality in hospitalized patients with COVID-19.”

A JAMA report on a study of more than 72,000 cases of COVID-19 in mainland China determined that people with diabetes had more than triple the death rate of those without diabetes—about 7% compared with about 2%.

Other studies, including one published in the European Journal of Allergy and Clinical Immunology, have not confirmed the greater risk for diabetes itself, although most have said older age, a high number of comorbidities, and more prominent laboratory abnormalities were associated with severity.

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