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Diabetic ketoacidosis threatens hospitalized patients with COVID-19

New approach to treatment protects healthcare providers from frequent close contact

Date:
June 18, 2020
Source:
The Endocrine Society
Summary:
Diabetic ketoacidosis is a common and potentially fatal complication in hospitalized patients with COVID-19, according to a new clinical perspective.
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Diabetic ketoacidosis is a common and potentially fatal complication in hospitalized patients with COVID-19, according to a new clinical perspective published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

Diabetic ketoacidosis almost always requires special care in the hospital which usually takes place in the intensive care unit (ICU). It is caused by insufficient insulin circulating in the bloodstream, which is more likely to occur during a serious infection like COVID-19. Diabetic ketoacidosis causes a buildup of acids in the blood, leading to serious illness characterized by dehydration and sometimes difficulty breathing.

"People with diabetes who are infected with COVID-19 are at increased risk of severe disease, which in some cases is accompanied by diabetic ketoacidosis," said the paper's corresponding author Marie McDonnell, M.D., of Brigham and Women's Hospital and Harvard Medical School in Boston, Mass. "Hospitals and clinicians need to be able to quickly identify and manage diabetic ketoacidosis in COVID patients to save lives. This involves determining the options for management (including when less intensive subcutaneous insulin is indicated) and understanding how to guide patients on avoiding this serious complication."

The authors outline simpler methods of diabetic ketoacidosis management with the goal of keeping ICU beds available for severe COVID-19 cases. They advocate, in select cases, for diabetic ketoacidosis protocols that use subcutaneous insulin therapy outside of the ICU instead of IV insulin therapy in the ICU to protect nurses from having to deliver frequent bedside care to COVID-infected patients.

Other topics include the importance of recognizing euglycemic ketoacidosis in those taking SGLT2-inhibitor agents and the recognition that unique approaches, including telemedicine, may be needed to help the highest risk patients avoid ketoacidosis.

Other authors include Nadine E. Palermo of Brigham and Women's Hospital and Harvard Medical School and Archana R. Sadhu of Houston Methodist Hospital and Weill Cornell Medical College in Houston, Texas. The manuscript did not receive external funding.

The manuscript, "Diabetic Ketoacidosis in COVID-19: Unique Concerns and Considerations," was published online, ahead of print.


Story Source:

Materials provided by The Endocrine Society. Note: Content may be edited for style and length.


Journal Reference:

  1. Marie E McDonnell, Archana R Sadhu, Nadine E Palermo. Diabetic Ketoacidosis in COVID-19: unique concerns and considerations. The Journal of Clinical Endocrinology & Metabolism, 2020; DOI: 10.1210/clinem/dgaa360

Cite This Page:

The Endocrine Society. "Diabetic ketoacidosis threatens hospitalized patients with COVID-19." ScienceDaily. ScienceDaily, 18 June 2020. <www.sciencedaily.com/releases/2020/06/200618092447.htm>.
The Endocrine Society. (2020, June 18). Diabetic ketoacidosis threatens hospitalized patients with COVID-19. ScienceDaily. Retrieved July 12, 2024 from www.sciencedaily.com/releases/2020/06/200618092447.htm
The Endocrine Society. "Diabetic ketoacidosis threatens hospitalized patients with COVID-19." ScienceDaily. www.sciencedaily.com/releases/2020/06/200618092447.htm (accessed July 12, 2024).

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