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Evidence summary: What is the effect of blood sugar control in mediating the increased risk of COVID-19 for people with diabetes? [v1.0]

dc.contributor.authorNational Health Library & Knowledge Service (NHLKS)
dc.contributor.authorHegarty, Ronan
dc.contributor.authorDelaunois, Isabelle
dc.contributor.authorLeen, Brendan
dc.date.accessioned2020-06-22T11:02:26Z
dc.date.available2020-06-22T11:02:26Z
dc.date.issued2020-05-18
dc.identifier.urihttp://hdl.handle.net/10147/627805
dc.descriptionThe overall quality of evidence specific to the question was low, consisting mainly of case series, case repots and expert opinion. However, it has been well established in the literature that COVID-19 can cause more severe symptoms and complications in people living with diabetes2, 7, 10, 15, 16. When people with diabetes develop a viral infection, it can be harder to treat due to fluctuations in blood glucose levels and possibly the presence of diabetes complications15. Infection with SARS-CoV-2 in people with diabetes may trigger an increased secretion of counter-regulatory hormones such as glucocorticoid and catecholamines which results in elevated blood glucose, abnormal glucose variability and other diabetic complications11. A study from the United States found that the median length of stay in patients with diabetes and/or uncontrolled hyperglycemia was greater than those without; the same study found a link between patients with uncontrolled hyperglycemia and a particularly high mortality rate3. Suggestions to help people with diabetes and SARS-CoV-2 infection include: 1. More frequent self-monitoring of blood glucose levels5 2. Patient tailored therapeutic strategies, rigorous glucose monitoring and careful consideration of drug interactions to reduce adverse outcomes6 3. Intensive monitoring and aggressive supportive care in order to support inadequately controlled patients with diabetes and COVID-19 infection 4. Ensuring sufficient diabetic equipment and supplies at home in order to make regular blood glucose self-tests and awareness to contact a caregiver immediately in case of glycemic imbalance or signs of infection 5. Insulin therapy should be considered to treat any persistent hyperglycemia in patients hospitalized for an acute infection 6. Inpatient glycemic control is particularly important in the comprehensive treatment of COVID-19. Individualized blood glucose goals and treatment strategies should be made according to specific circumstances of COVID-19 inpatients with diabetes 7. Blood glucose monitoring, dynamic evaluation and timely adjustment of strategies should be strengthened to ensure patient safety and promote early recovery9 One study reported that good blood glucose control may act as an effective auxiliary approach to improve the prognosis of patients with COVID-19 and pre-existing diabetes. Those with better-controlled blood sugar levels and a generally healthier lifestyle are less likely to suffer serious consequences from COVID-19 and are less likely to die from complications 16. Management of people with diabetes with COVID-19 generally follows standard sick-day rules14, which may include being aware of the signs and symptoms of hypoglycemia and hyperglycemia. Antidiabetic therapy may need adjustments following usual sick day rules.en_US
dc.language.isoenen_US
dc.publisherHealth Service Executiveen_US
dc.relation.ispartofseriesEvidence summariesen_US
dc.subjectCORONAVIRUSen_US
dc.subjectCOVID-19en_US
dc.subjectDIABETES MELLITUSen_US
dc.titleEvidence summary: What is the effect of blood sugar control in mediating the increased risk of COVID-19 for people with diabetes? [v1.0]en_US
dc.typeOtheren_US
refterms.dateFOA2020-06-22T11:02:27Z


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