A Pragmatic Approach to Inpatient Diabetes Management during the COVID-19 Pandemic
| Autor: | Marie E. McDonnell, Andjela Drincic, Irl B. Hirsch, Kellie J. Antinori-Lent, Robert J. Rushakoff, Ranganath Muniyappa, Mary T. Korytkowski |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty insulin Sars-CoV-2 Endocrinology Diabetes and Metabolism Clinical Biochemistry Pneumonia Viral Hypoglycemia Biochemistry Betacoronavirus Endocrinology Diabetes management Intensive care Internal medicine Intervention (counseling) Diabetes mellitus Health care medicine Diabetes Mellitus Humans hospital Intensive care medicine Invited Approach to the Patient Personal protective equipment Pandemics Glycemic Inpatients diabetes business.industry Biochemistry (medical) COVID-19 Middle Aged medicine.disease Practice Guidelines as Topic hyperglycemia business Coronavirus Infections AcademicSubjects/MED00250 |
| Zdroj: | The Journal of Clinical Endocrinology and Metabolism |
| ISSN: | 1945-7197 0021-972X |
| Popis: | The pandemic of COVID-19 has presented new challenges to hospital personnel providing care for infected patients with diabetes who represent more than 20% of critically ill patients in intensive care units. Appropriate glycemic management contributes to a reduction in adverse clinical outcomes in acute illness but also requires intensive patient interactions for bedside glucose monitoring, intravenous and subcutaneous insulin administration, as well as rapid intervention for hypoglycemia events. These tasks are required at a time when minimizing patient interactions is recommended as a way of avoiding prolonged exposure to COVID-19 by health care personnel who often practice in settings with limited supplies of personal protective equipment. The purpose of this manuscript is to provide guidance for clinicians for reconciling recommended standards of care for infected hospitalized patients with diabetes while also addressing the daily realities of an overwhelmed health care system in many areas of the country. The use of modified protocols for insulin administration, bedside glucose monitoring, and medications such as glucocorticoids and hydroxychloroquine that may affect glycemic control are discussed. Continuous glucose monitoring systems have been proposed as an option for reducing time spent with patients, but there are important issues that need to be addressed if these are used in hospitalized patients. On-site and remote glucose management teams have potential to provide guidance in areas where there are shortages of personnel who have expertise in inpatient glycemic management. |
| Databáze: | OpenAIRE |
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