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The Hospital for Sick Children
Endocrinology

Coronavirus (COVID-19) Resources

We are receiving many questions about Coronavirus (COVID-19) and implications for individuals with diabetes and/or adrenal insufficiency.

Advice for people with diabetes and/or adrenal insufficiency aligns with general advice:

  • Wash hands frequently
  • Maintain social distance
  • Self-isolate and seek care quickly if you think you may be infected with COVID-19 (following directions of your local health authority).

SickKids is closely monitoring the COVID-19 situation and taking precautions to maintain safe and effective care. We will be in touch with you prior to your child’s next clinic appointment to assess the possibility of completing a virtual visit. The date and time of your/your child’s appointment would stay the same, but the doctor would connect with you by phone or video chat.

Before coming to SickKids, learn more about visitor restrictions, screening and virtual care options on our Coronavirus (COVID-19) Information page.

Guidance for individuals with diabetes:

Those living with type 1 diabetes (T1D) are not at increased risk of acquiring COVID-19

  • As with other infections, people with poorly controlled T1D or with complications (such as renal failure) might be at heightened risk once infected with COVID-19.
  • Viruses, in general, can cause blood glucose disturbances such as hyperglycemia, Diabetic ketoacidosis (DKA), etc., sometimes leading to hospitalization.
  • It is important to follow the management guidelines for sick days with diabetes. For more information, please review the resources below.
  • Stock your cupboards with items that will support a healthy intake of carbohydrates and ensure you have diabetes medical supplies on hand for at least 14 days if you are quarantined.
  • Have your diabetes team phone numbers handy. For non-urgent questions, please contact them during the daytime. 
    For more urgent concerns (vomiting or diarrhea for more than six hours; large levels of ketones; and an inability to keep food or liquid down) patients followed at SickKids can call Hospital Locating and ask to speak to the Diabetes doctor on-call.
    Patients that are not currently followed at SickKids are advised to consult their current health teams.
  • Review your supply of insulin and diabetes supplies to ensure that you have an adequate supply for the next 1-2 months. 
    For current SickKids patients: If you are running low, please check if you have refills available on-file with your pharmacy (will appear on the label as R:) and have the pharmacy send a refill request form to the Division of Endocrinology fax at 416-813-6304 if refills are needed.

We have reached out to type 1 diabetes device and insulin manufacturers to inquire whether supply could be affected by disruptions in manufacturing or shipping related to COVID-19. All those we have heard from to-date have assured us there is no concern about supply in Canada.

Diabetes resources

 

Guidance for individuals with adrenal insufficiency

Individuals with adrenal insufficiency are no more likely to get the COVID-19 virus than others.  If such individuals do become sick, however, it is important to apply stress-dose guidelines as prescribed by your physician. For more information, please review the resources below.

  • If you do not remember your stress dose for illness, contact your physician or nurse to get this information.
  • Anyone with fever, vomiting or diarrhea should adhere to their stress-doses. If your child is ill and you are unsure if they require stress dosing with hydrocortisone, patients followed at SickKids can call hospital locating and ask to speak to the Endocrine doctor on-call. Patients that are not currently followed at SickKids are advised to contact their current health teams.
  • Review your supply of steroid medications (both oral and injectable) to ensure that you have an adequate supply for the next 1-2 months and that the injection is not expired (or near expiration).  
    For current SickKids patients: If you are running low, please check if you have refills available on-file with your pharmacy (will appear on the label as R:) and have the pharmacy send a refill request form to the Division of Endocrinology fax at 416-813-6304 if refills are needed.
  • It is important to know that ambulance paramedics are permitted to administer injectable hydrocortisone, if supplied by a patient (they do not stock hydrocortisone on the ambulances).

For emergencies, patients that are currently followed at SickKids can contact the on-call Endocrine doctor at any time by calling Hospital Locating.  Given the high number of calls, we ask that you contact your health-care team during the daytime if your question is not urgent so that we may direct our attention to those in most immediate need of care.
Patients that are not currently followed at SickKids are advised to consult their current health teams.

Adrenal insufficiency resources

We should all exercise safe practice and avoid panic. 
Learn more about ways to balance how we react and act.

How we speak to our children is also important.
Learn more about how to talk with your child about COVID-19.


General Resources