Coronavirus Triggers Unique Fears in People with Diabetes

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Last week we reported on the CDC’s recommendation that people with diabetes near a known coronavirus (COVID-19) outbreak should stay inside their homes as much as possible. In order to facilitate that, the CDC further recommends that people with diabetes should now stock up on medical supplies and essentials, so that later trips to the grocery store or pharmacy can be avoided.

Those articles prompted much commentary from our readers, much of it sad, some of it angry.

Several readers commented that they could not afford to stockpile supplies.

Several readers commented on the fact that American insurance plans typically do not even allow stockpiling of any sort.

Several readers have jobs that will not allow them to work from home, or do not have the time or wherewithal to place a loved one with diabetes into a self-imposed isolation.

This isn’t the time to decry America’s woeful healthcare system, its meager protections for employees, or its ever-increasing wealth disparities. We have covered these issues in the past, but everything we’ve ever said and thought about these problems seems suddenly out of date. The coronavirus pandemic has the potential to change the debate on all of these issues permanently, as the economic downturn and overburdened health system may thrust these issues to the fore in a way that’s never happened before.

But none of that is any help for people with diabetes who are in need today.

Life with diabetes can be difficult even during the best of times, and for some, the sudden attention paid to the inequities of modern society aren’t news, they’re just a reminder of life with diabetes. Memes circulated in recent days comparing the instantly notorious Tennessee profiteer who bought and sold thousands of bottles of hand sanitizer with the pharmaceutical companies that reportedly manufacture a vial of insulin for about $5while charging over $150. The former sparked viral outrage and immediate legal action; the latter is an entrenched fact of the American healthcare system that we confront every time we go to the pharmacy. We hope to see Lilly, Novo Nordisk, and Sanofi dramatically lowering the price of insulin during the coronavirus crisis. During this emergency, people will struggle even more to afford their life-saving medications.

Several websites have published lists of resources for people with diabetes who are struggling with the above issues. The Diabetes Disaster Response Coalition publishes a disaster preparedness plan with an easy-to-use checklist. Their resources page also lists numbers and websites that may be of use to people with diabetes in need. One such resource is the Emergency Diabetes Supply Hotline (phone number 1-314-INSULIN). Diabetes Daily has published a helpful guide to securing extra diabetes supplies. Ideas include switching to less expensive, over-the-counter glucose meter and strips and requesting a “vacation” supply of prescription medication. And scattered reports suggest that with the declaration of state and national emergencies, requests to insurance companies for disaster overrides are likely to be approved, granting a 90-day supply rather than a mere 30 days. Guides to traveling with diabetes like this one and this one are full of tips for preparing diabetes supplies in advance.

Social distancing can be difficult to bear, but it’s critical to containing coronavirus. For some people with diabetes, the prevention may end up feeling worse than the disease. With medical experts across the globe urging people to self-isolate and practice extreme social distancing, and governments enforcing broad bans and lockdowns on public leisure activities and gatherings, much of the world has been abruptly forced into the kind of profoundly lonely and idle lifestyle that is well known to foster depression. It should come as no surprise that experts say these measures could have a “devastating effect” on people who are already experiencing depression. That’s no small matter for the diabetes community. Diabetes and mental health are inextricably linked: people with diabetes are about twice as likely to suffer from depression as people without, probably due to the accumulated stress of daily diabetes management and the insidious effect of negative health consequences.

Isolation and quarantine, whether self-imposed or mandated, will surely cause plenty of diabetes burnout, where lack of motivation and slipping control leads to poorer health and, in a vicious cycle, thereafter to even lower motivation and worse control. Keeping spirits up for the next strange few weeks or months may be a challenge, but given the speculation that good glucose control can protect people with diabetes both from initial infection with COVID-19 and from the actual progression of the disease once infected, it should be seen as a critical goal.

That people with diabetes are specifically asked to self-isolate to a greater degree than their healthy peers just makes the situation that much more impossible. Meanwhile, a rash of panic shopping, often by healthy consumers, has made it difficult for “higher risk” consumers to actually do the stockpiling of food and supplies they’ve been instructed to do.

There’s no doubt that this is a uniquely challenging time for people with diabetes. The COVID-19 pandemic has the potential to harm and kill many people with diabetes. And the pandemic can take a toll on all of us, even those lucky enough to escape the virus’ direct path. The American healthcare system – which already exhibited almost limitless capacity to frustrate and enrage – will be stretched to the breaking point, and maybe beyond it. And many will have to confront private demons in isolation, with few options for the socialization, exercise or moral support that might help pull us out of the doldrums.

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