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Hospital guidance for COVID-19 and diabetes care are published

Guidance to help healthcare professionals better manage people with diabetes who are admitted to hospital with COVID-19 have been published.

The pandemic has presented new challenges to hospital staff providing care for these people who either have type 1 or type 2 diabetes.

Figures have shown that 25 to 34 per cent of the patient population receiving care in an intensive care unit (ICU) and non-ICU settings are reliant on appropriate glycaemic management.

One of the main challenges is how medication requirements can vary on a daily, if not hourly basis, among people with insulin-dependent diabetes and COVID-19.

Reports from healthcare professionals have shown there is “significant variability” in both subcutaneous insulin and intravenous (IV) insulin dosing from low to very high requirements.

In addition, those who are admitted to hospital with COVID-19 and have acute kidney damage may be “particularly sensitive” to insulin and hypoglycaemia.

Lead author Dr Mary T Korytkowski, from the University of Pittsburgh School of Medicine in Pittsburgh, said: “This manuscript provides guidance for healthcare providers caring for patients hospitalised for COVID-19 who also have a prior history of diabetes or who have high blood sugar levels at the time of hospitalisation.

“These healthcare providers are at risk for contracting COVID-19, and while glycaemic management in the hospital improves patient outcomes, it also intensifies the amount of time with direct patient contact.”

At the moment there are several studies being carried out to investigate the best therapy strategies for determining the best diabetes outcomes among those become infected with COVID-19.

However, for the time being healthcare professionals are being advised to limit their exposure time to people with diabetes who have tested positive for coronavirus.

Current suggestions involve minimising the use of IV insulin infusions in critically ill people, using remote continuous glucose monitoring devices (CGM) devices to minimise time spent in direct patient contract, and reconsidering use of non-insulin therapies.

In addition, hospitals are being urged to encourage people with diabetes to become more involved in self-management education.

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