Early Observation and Mitigation of Challenges in Diabetes Management of COVID-19 Patients in Critical Care Units
Osama Hamdy, Robert A. Gabbay
Abstract
Clinical studies of patients with coronavirus disease 2019 (COVID-19) have found diabetes to be a major risk factor for disease severity and mortality (1,2). One new study showed that COVID-19 patients with diabetes and/or uncontrolled hyperglycemia had a longer length of stay and markedly higher mortality than patients without diabetes or uncontrolled hyperglycemia (3). Given rising numbers of cases of patients with COVID-19 and diabetes, understanding their interaction on insulin requirement and glycemic control is prudent. As seen in other infections, blood glucose starts to rise with the beginning of clinical symptoms. By the time the patient is admitted to the intensive care unit (ICU), insulin requirement is at its highest, and blood glucose remains high if not properly managed. Treating physicians face several challenges that need careful attention.