Living with type 1 diabetes (T1D) can be challenging. Every day you must make choices that will affect your diabetes and your life. This is particularly true when you are sick. If not cared for properly, even a minor cold can make your diabetes harder to control and lead to severe complications like diabetic ketoacidosis (DKA).
Diabetic ketoacidosis is a condition that occurs when the body does not have enough insulin to use glucose for energy and starts burning fats. But fat isn’t clean fuel; it leaves an acidic waste in your bloodstream called ketones.
Your body can get rid of some, but not all, of the ketones by excreting them in the urine. Eventually, they’ll build up—an acidic poison in the bloodstream.
A recent study in the Journal of Clinical Endocrinology & Metabolism analyzed data from 180 people with T1D and COVID-19 from 52 clinical sites in the United States.
The study found Black patients were four times more likely than whites to be hospitalized for DKA. Black patients were also less likely to use diabetes technology like continuous glucose monitors (CGMs) and insulin pumps, and they had worse glucose control than white patients.
Black patients’ A1C was 11.7 percent compared with 8.3 percent in white patients. Target A1C for diabetes control is no more than 7.0 percent. These findings suggest Black patients with COVID-19 and T1D have an additional risk of DKA beyond the usual risk associated with TID.
Technology can make it easier to manage diabetes. When you get sick, it’s more important to keep your blood glucose in control—but it’s also harder to do. Continuous glucose monitoring automatically tracks glucose levels throughout the day and night. You can see your glucose level anytime at a glance. The ability to see your glucose levels in real-time is especially helpful in preventing DKA.
It’s also important to keep taking your insulin when sick. COVID-19 is stressful to the body, and the stress hormones that are released cause the liver to produce more glucose, resulting in high glucose levels. You might have to take more insulin than usual to bring your blood glucose levels down.