Clinical Management of Diabetes Mellitus in the Era of COVID-19: Practical Issues, Peculiarities and Concerns.
Chrysi KoliakiAnastasios TentolourisIoanna EleftheriadouAndreas MelidonisGeorge D DimitriadisNikolaos TentolourisPublished in: Journal of clinical medicine (2020)
The management of patients with diabetes mellitus (DM) in the era of the COVID-19 pandemic can be challenging. Even if they are not infected, they are at risk of dysregulated glycemic control due to the restrictive measures which compromise and disrupt healthcare delivery. In the case of infection, people with DM have an increased risk of developing severe complications. The major principles of optimal care for mild outpatient cases include a patient-tailored therapeutic approach, regular glucose monitoring and adherence to medical recommendations regarding lifestyle measures and drug treatment. For critically ill hospitalized patients, tight monitoring of glucose, fluids, electrolytes, pH and blood ketones is of paramount importance to optimize outcomes. All patients with DM do not have an equally increased risk for severity and mortality due to COVID-19. Certain clinical and biological characteristics determine high-risk phenotypes within the DM population and such prognostic markers need to be characterized in future studies. Further research is needed to examine which subgroups of DM patients are expected to benefit the most from specific antiviral, immunomodulatory and other treatment strategies in the context of patient-tailored precision medicine, which emerges as an urgent priority in the era of COVID-19.
Keyphrases
- glycemic control
- blood glucose
- type diabetes
- coronavirus disease
- healthcare
- sars cov
- weight loss
- end stage renal disease
- insulin resistance
- ejection fraction
- case report
- chronic kidney disease
- metabolic syndrome
- palliative care
- cardiovascular disease
- respiratory syndrome coronavirus
- prognostic factors
- physical activity
- peritoneal dialysis
- patient reported outcomes
- ionic liquid
- cardiovascular events
- skeletal muscle
- blood pressure
- solid state
- social media
- chronic pain
- adipose tissue
- clinical practice
- affordable care act
- health insurance