tetano
Editor, Senior Moderator
Diabetes
. 2020 Aug 10;dbi200022.
doi: 10.2337/dbi20-0022. Online ahead of print.
Managing Hyperglycemia in the COVID-19 Inflammatory Storm
Roma Gianchandani[SUP] 1 [/SUP], Nazanene H Esfandiari[SUP] 2 [/SUP], Lynn Ang[SUP] 2 [/SUP], Jennifer Iyengar[SUP] 2 [/SUP], Sharon Knotts[SUP] 2 [/SUP], Palak Choksi[SUP] 2 [/SUP], Rodica Pop-Busui[SUP] 2 [/SUP]
Affiliations
Abstract
A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]) is now at global pandemic levels causing significant morbidity and mortality. Patients with diabetes are particularly vulnerable and more likely to get severe complications when infected with this virus. Although the information continues to emerge, here we provide our perspective on initial outcomes observed in hospitalized patients with diabetes and the potential role played by the proinflammatory metabolic state in these patients that promotes fertile ground for the virus' inflammatory surge, resulting in severe insulin resistance and severe hyperglycemia. The rapidly evolving renal failure, hypotension, pressor and steroid use, and variable nutritional support further complicates their management. Thus, timely implementation of glucose management protocols addressing these complex scenarios while also following COVID-19-related trajectories in inflammatory biomarkers and being cognizant of the health care provider exposure may substantially affect morbidity and mortality.
. 2020 Aug 10;dbi200022.
doi: 10.2337/dbi20-0022. Online ahead of print.
Managing Hyperglycemia in the COVID-19 Inflammatory Storm
Roma Gianchandani[SUP] 1 [/SUP], Nazanene H Esfandiari[SUP] 2 [/SUP], Lynn Ang[SUP] 2 [/SUP], Jennifer Iyengar[SUP] 2 [/SUP], Sharon Knotts[SUP] 2 [/SUP], Palak Choksi[SUP] 2 [/SUP], Rodica Pop-Busui[SUP] 2 [/SUP]
Affiliations
- PMID: 32778570
- DOI: 10.2337/dbi20-0022
Abstract
A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]) is now at global pandemic levels causing significant morbidity and mortality. Patients with diabetes are particularly vulnerable and more likely to get severe complications when infected with this virus. Although the information continues to emerge, here we provide our perspective on initial outcomes observed in hospitalized patients with diabetes and the potential role played by the proinflammatory metabolic state in these patients that promotes fertile ground for the virus' inflammatory surge, resulting in severe insulin resistance and severe hyperglycemia. The rapidly evolving renal failure, hypotension, pressor and steroid use, and variable nutritional support further complicates their management. Thus, timely implementation of glucose management protocols addressing these complex scenarios while also following COVID-19-related trajectories in inflammatory biomarkers and being cognizant of the health care provider exposure may substantially affect morbidity and mortality.