Expert group practical recommendations: management of diabetes in COVID-19 patients
Data show that most people with COVID-19 have co-morbidities, the most prevalent of which are diabetes, cardiovascular disease, and hypertension. People with these comorbidities have significantly worse outcomes. Studies have also shown that COVID-19 is associated with hyperglycaemia particularly in the elderly with type 2 diabetes.
An international faculty of eminent representatives from primary and specialist care have developed a consensus document on the management of diabetes for people at risk of, or with confirmed COVID-19, for use in both primary and secondary care.
Published in The Lancet Diabetes and Endocrinology,1 the brief practical recommendations are based on queries seen to be important by clinicians, questions that have been raised by colleagues and social media, and recommendations guided by using focused-literature review.
Clinical decision making in the management of diabetes is already complex and in normal circumstances clinicians follow standard guidelines. However, the recommendations authored by this group add to existing guidelines by considering specific points for the management of patients with diabetes and COVID-19 disease or at risk for metabolic disease.
The document provides insight into potential mechanistic links between the novel coronavirus infection and diabetes, presents practical management recommendations, and elaborates on the differential needs of several patient groups.
1. Bornstein SR, Birkenfield AL, Ludwig B, et al. Practicial recommendations for the management of diabetes in patients with COVID-19. Lancet Diabetes Endocrinol 2020;8:546–50. https://doi.org/10.1016/S2213-8587(20)30152-2
New e-learning programmes from EASD
How do you continue to deliver quality diabetes care during a pandemic? Why are so many of your patients at such high risk of severe infection? And what do non-diabetes specialists caring for people with diabetes in hospital need to know?
To help healthcare professionals get to grips with these and many other questions in this new pandemic era, The European Association for the Study of Diabetes (EASD) has created a new e-Learning section on its site https://easd-elearning.org/ to provide short, accessible learning from leading experts.
One of the online courses focuses on cardiovascular health – one of the most significant and challenging aspects of care for type 1 and type 2 diabetes. There is also a course on diabetes and the kidney, which features a module on the tips and tricks for the use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) and SGLT2 inhibitors.
Another course has been designed to give an overview of phenotypic variability in people with type 2 diabetes, its importance in relation to delivering patient-centred care, and how phenotyping – as well as genotyping – can assist in more precise selection and timing of diabetes treatments.
Other articles in this bulletin:
COVID-19 and the heart
• A review of the current data on the association of COVID-19 and the heart
COVID-19 and cardiac rhythm management
• BHRS video series
COVID-19 and cardiac rehabilitation
• Joint BACPR/BCS/BHF statement on cardiac rehabilitation services
COVID-19 and smartphone apps
• Which apps have been increasingly useful to clinicians during the pandemic