Most people with COVID-19 do not need to go to the hospital, including those with diabetes. However, diabetes may increase the risk of severe illness. People who have breathing problems and chest pain with COVID-19 should go to the hospital.

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.

Coronavirus data

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 Some information may be out of date.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 COVID-19.

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As 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 breathing
  • pain in the chest
  • inability to stay awake
  • new confusion
  • blue, 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.

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.

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 prescription
  • testing blood sugar every 4 hours
  • eating normally
  • drinking extra calorie-free liquids
  • checking weight daily, as weight loss without trying may indicate high blood sugar
  • checking 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).

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 water
  • avoiding crowds
  • wearing a properly fitted mask in poorly ventilated indoor settings

The CDC adds that further precautions may include:

  • avoiding contact with people who are sick
  • taking a SARS-CoV-2 test after a known exposure
  • staying 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-19
  • checking blood sugar often
  • maintaining hydration
  • continuing to take diabetes medications

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.