Managing Hyperglycemia In The Covid-19 Inflammatory Storm

A novel Coronavirus, SARS-CoV-2 (COVID-19) is now at global pandemic levels causing significant morbidity and mortality. Patients with diabetes are particularly vulnerable and more likely to get severe complications when infected with this virus. Although the information continues to emerge, here we provide our perspective on initial outcomes observed in hospitalized patients with diabetes and the potential role played by the pro inflammatory metabolic state in these patients that promotes fertile ground for the virus’ inflammatory surge, resulting in severe insulin resistance and severe hyperglycemia. The rapidly evolving renal failure, hypotension, pressor and steroid use, and variable nutritional support further complicates their management. Thus, timely implementation of glucose management protocols addressing these complex scenarios while also following COVID-19 related trajectories in inflammatory biomarkers and are cognizant of the health care provider exposure may substantially affect morbidity and mortality.