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2020 ; 11
(9
): 2177-2194
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English Wikipedia
Basal-Bolus Insulin Regimen for Hospitalised Patients with COVID-19 and Diabetes
Mellitus: A Practical Approach
#MMPMID32683660
Attri B
; Goyal A
; Gupta Y
; Tandon N
Diabetes Ther
2020[Sep]; 11
(9
): 2177-2194
PMID32683660
show ga
BACKGROUND AND AIM: The coronavirus disease 2019 (COVID-19) outbreak has rapidly
crossed international boundaries and placed increasing demands on healthcare
facilities worldwide. Patients with diabetes and uncontrolled blood glucose
levels are at increased risk for poor clinical outcomes and in-hospital mortality
related to COVID-19. Therefore, achieving good glycaemic control is of paramount
importance among hospitalised patients with COVID-19. Basal-bolus insulin therapy
is a safe and effective intervention for the management of hyperglycaemia in
hospitalised patients. The aim of this article is to provide a practical guidance
for the use of the basal-bolus insulin regimen in hospitalised patients with
COVID-19 and diabetes mellitus. METHODS: This guidance document was formulated
based on the review of available literature and the combined personal experiences
of the authors. We provide a comprehensive review on the use of the basal-bolus
insulin regimen, including its principles, rationale, indications, prerequisites,
initiation, and dose titration, and also suggest targets for blood glucose
control and different levels of capillary blood glucose monitoring. Various case
scenarios are used to illustrate how optimal glucose control can be achieved,
such as through adjustments in doses of prandial and basal insulin, the use of
correctional insulin dosing and changes in the timing and content of major and
minor meals. CONCLUSION: The practical guidance for the use of the basal-bolus
insulin regimen in hospitalised patients with COVID-19 and diabetes mellitus
presented here can be used for patients admitted to hospital for indications
other than COVID-19 and for those in ambulatory care.
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