Our March 31st Question of the week was a question about COVID-19, sick days and diabetes. Although 40% of respondents chose the correct answer, 60% did not. We thought that this was an important topic to discuss further, so we can pass on correct info to people living with diabetes.

Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question

JR is 27 with Type 1 diabetes and is very worried about getting COVID-19 since they work in a local grocery store.  They ask you what they should do if they get COVID-19?

Which of the following statements is accurate regarding sick day management with COVID-19?

Answer Choices:

1. Seek immediate medical attention if lips or face become bluish.
2. Report to the emergency room if the temperature is 101 degrees or greater.
3. Reduce insulin intake by 10-20% if experiencing diarrhea.
4. Use glucose fingersticks instead of continuous glucose monitoring (CGM) when febrile to improve accuracy.

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As shown above, the most common choice was option 1, the second most common answer was option 4, then option 2, and finally option 3.

Only 39% of participants chose the correct answer number 3, which means there is a learning opportunity!

Answer 1 is Correct! Seek immediate medical attention if lips or face become bluish. Bluish lips or face indicates hypoxia and signals urgent medical care is needed.

From ADA Sick Day Information. If develop emergency warning signs for COVID-19 get medical attention immediately.

In adults, emergency warning signs include:

• Difficulty breathing or shortness of breath
• Persistent pain or pressure in the chest
• New confusion or inability to arouse
• Bluish lips or face

Option 2 is incorrect. One-fifth of respondents chose ” Report to the emergency room if the temperature is 101 degrees or greater.” In the case of fever, the next step would to be to contact your provider to evaluate presence of cough, shortness of breath and other symptoms to determine if urgent care is required.

Option 3 is also incorrect. “Reduce insulin intake by 10-20% if experiencing diarrhea.” During periods of illness, inflammation leads to insulin resistance and hyperglycemia. Most people will need to increase insulin dose during illness, including GI distress.

Finally, Option 4 is incorrect. “Use glucose fingersticks instead of continuous glucose monitoring when febrile to improve accuracy.”
Fever by itself does not interfere with CGM accuracy. If a person is taking Tylenol, it can interfere with the accuracy certain CGMs. And, CGM use is not recommended in the Intensive Care setting. But, having a temperature by itself, does not interfere with CGM accuracy.

Here is a COVID and Sick Day Handout that you can share with your community. Thank you for helping us get the word out.

For more information on sick day management and when to seek medical care, please see this ADA Sick Day Information. 

We hope you appreciate this week’s rationale and keep studying hard! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!

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