Glucose Management of COVID-19 Patients in the ICU Gets New Provider Guidelines

June 10, 2020

According to the report, more than 20 percent of COVID patients in the ICU are patients with diabetes, presenting challenges for the clinicians managing their care.  Diabetic patients with COVID-19 in the ICU need both complex medical management of their COVID disease, along with blood sugar control to minimize complications and mortality risk- and that can require multiple patient interactions that put the provider at risk.

New guidelines for glucose management in diabetic COVID patients were published recently in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.  

According to the report, more than 20 percent of COVID patients in the ICU are patients with diabetes, presenting challenges for the clinicians managing their care.  Diabetic patients with COVID-19 in the ICU need both complex medical management of their COVID disease, along with blood sugar control to minimize complications and mortality risk- and that can require multiple patient interactions that put the provider at risk.

“This manuscript provides guidance for healthcare providers caring for patients hospitalized for COVID-19 who also have a prior history of diabetes or who have high blood sugar levels at the time of hospitalization,” said lead author Mary T. Korytkowski, M.D., of the University of Pittsburgh School of Medicine in Pittsburgh, Pa. “These healthcare providers are at risk for contracting COVID-19, and while glycemic management in the hospital improves patient outcomes, it also intensifies the amount of time with direct patient contact.”

Clinicians may limit their risk of exposure by minimizing the use of IV insulin infusions and using remote glucose monitoring devices and non-insulin therapies when possible. Diabetes self-management by selected patients who are knowledgeable and capable of this in the hospital also can be considered as a way of limiting direct patient interactions. Clinicians should be aware that some medications used in treating COVID-19 patients, including glucocorticoids and hydroxychloroquine, can affect blood glucose levels.

Korytkowski M, Antinori-Lent K, Drincic A, et al. A Pragmatic Approach to Inpatient Diabetes Management during the COVID-19 Pandemic [published online ahead of print, 2020 Jun 4]. J Clin Endocrinol Metab. 2020;dgaa342. doi:10.1210/clinem/dgaa342