A recent article published in The Lancet Diabetes & Endocrinology stated that diabetes is one of the most common comorbidities linked to the severity of all three known human pathogenic coronavirus infections, including severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Diabetic patients have an increased risk of severe complications of coronavirus disease 2019 (COVID-19), including Adult Respiratory Distress Syndrome (ARDS) and multi-organ failure. 

Reports suggest that about 20-50% of patients in the COVID-19 pandemic had diabetes. Given the importance of the link between COVID-19 and diabetes, an international panel of experts in the field of diabetes and endocrinology were appointed to provide guidance and practical recommendations for the management of diabetes during the pandemic. 

This article presents practical management recommendations for diabetes management in this pandemic situation:

• Most patients will require insulin, owing to multiple stresses associated with COVID-19 and the high insulin consumption; i.v. insulin should be utilized
• Fluid balance must be maintained as excessive fluid can exacerbate pulmonary oedema in a severely inflamed lung.
• Potassium balance mustbe carefully monitored during insulin treatment as hypokalemiais a common feature, which can exacerbate following initiation of insulin.

Source: The Lancet Diabetes & Endocrinology. 2020 Jun;8(6):546-550. doi: 10.1016/S2213-8587(20)30152-2.