We are now facing the unprecedented outbreak of coronavirus disease 2019 (COVID-19) caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Diabetes Mellitus is one of the most important risk factors for severe coronavirus infection. Due to the reduced immunity in patients with diabetes, they are more prone to infections, similar to coronavirus. Up to 80% of COVID-19 infected patients experience mild symptoms. Diabetic patients may develop severe disease, especially if they are elderly patients, have uncontrolled blood glucose, and have associated comorbidities like hypertension, heart diseases, obesity, lung diseases, and cancers.

The strict control of blood glucose is essential to prevent the infection and reduce the severity of the infection.

• If you have a mild infection, you need not change your diabetes medicines, including oral medication and insulin, if your blood glucose is under control.
• But frequent monitoring of blood glucose is required.

Continue a healthy lifestyle like proper diet and regular exercise.

1. If you are taking insulin, you should continue insulin but adjust the dose according to your blood glucose levels.
2. You may require to increase the dose of insulin due to the infection.

Watch for symptoms of hypoglycemia (low blood glucose) like giddiness, palpitations, sweating, and hunger. If glucometer is available, check your blood glucose levels, if it is low (less than 70 mg/dl), take some glucose water or sugar candy and contact your doctor. In case of severe infection, oral antidiabetic medication is not that effective and safe. In that situation, insulin is the best treatment for the control of blood glucose. In patients with type 1 diabetes with COVID-19 and hyperglycemia, monitor blood glucose frequently, if the glucose levels are high, check urine ketone levels if possible, take a lot of fluids, increase the dose of insulin, sick day guidelines and contact your doctor.