Study investigates the role of hyperglycemia in COVID-19 severity

With COVID-19 raging across the nation, researchers are delving deeper into how the virus can hit the body, especially those with pre-existing chronic illnesses.

Now, after a preliminary observation of 200 COVID-19 patients with severe hyperglycemia, the Michigan Medical Team sheds light on a new American Diabetes Association paper on why Hyperglycemia It can cause bad results for people infected with the virus. And the researchers blood sugar Management tools that can potentially reduce the risk of secondary infections, kidney problems, and intensive care only remain in people with COVID-19 who have diabetes, prediabetes, or obesity.

“Based on preliminary observations in our patients, patients with one of these pre-existing conditions are far more likely to exacerbate viral-induced respiratory dysfunction and potentially death.” Metabolism , Endocrinology, Internal Medicine of the Michigan Medical Department of Diabetes.

but why?

Senior Author Rodica Pop Busui MD Dr. Larry. Professor Soderquist of D-Diabetes, Professor of Internal Medicine, Vice-Chairman of Internal Medicine’s clinical research, promotes viral inflammatory surges and causes insulin resistance and severe hyperglycemia in low diabetes and hyperglycemia. Suspected to be inflammatory with a grade of malignancy.

“This inflammation in the body not only attacks the virus, but also causes an abnormal immune response that affects other healthy cells and tissues in the body, leading to a rapid deterioration in health,” she says. I will.

Specifically, these patients are at high risk of mechanical ventilation, renal replacement therapy due to renal failure, or drug therapy known as pressor to stop dangerous hypotension to combat acute respiratory distress syndrome. I need steroids.

“All of these complications make glycemic control difficult, but our team is convinced that this management is essential to prevent complications that can lead to hospitalization or morbidity for long-term inpatients.” Gianchandani says. “Recent studies have already shown a correlation between well-controlled blood glucose levels and low levels of inflammatory markers.”

The research team has developed tools to identify and control hyperglycemia in COVID-19 patients and determine the severity of hyperglycemia, the presence, and level of obesity. Insulin resistance, Evidence of rapid changes in renal dysfunction, and inflammatory markers.

Algorithm implementation

The newly established hyperglycemic control team has begun to look for ways to monitor a patient’s diabetes without the need to use personal protective equipment to constantly visit the room. It was also important to reduce health care provider exposure to the virus as much as possible.

Usually accurate, but continuous glucose monitoring Low blood pressure Using blood pressure medications can inadvertently raise your blood sugar.

The new protocol required insulin to be given every 6 hours, with the nurse seeing the patient at the same time. Some patients who are on a ventilator or who are receiving high doses of Vitamin C have their arterial or venous blood glucose checked, replacing the team’s need for blood glucose checking.

For those with the highest blood sugar levels and severe hyperglycemia, insulin infusion was the patient’s option until their levels were within the normal range.

As a result of these efforts, we were able to successfully lower blood glucose levels without increasing nurse contact and overall burden on primary care teams and the use of PPE.

“Improving glycemic control was important in reducing the amount of secondary infections and kidney problems that this cohort of patients were susceptible to,” Gianchandani said. “This may help shorten ICU stays and reduce the amount of patients who need ventilators.”

It is important to note that this algorithm was not developed as a result of clinical trials, but only based on preliminary patient observations followed by the team. Larger randomized controlled studies are needed to determine how this algorithm affects mortality, time to recovery, length of stay in ICU, and incidence of severe complications ..

“Our team looks forward to the next step in confirming the hypothesis,” says Gianchandani. “In the meantime, these observations Blood sugar COVID-19 Patient Management serves as a guide or inspiration for other institutions. ”