Is subcutaneous insulin administration adequate for the management of hyperglycemic crisis in COVID-19?

Hikmat Permana, Nanny Natalia M. Soetedjo
2020 Diabetes & Metabolic syndrome: clinical Research & Reviews  
There is a desperate need to explore different insulin administration strategies, particularly in coronavirus disease 2019 (COVID-19) patients with hyperglycemic crisis. Noteworthily, diabetes mellitus (DM) and poorly controlled blood glucose increase the risk of mortality and severity of COVID-19. Intravenous (IV) insulin administration with hourly monitoring of blood glucose is the ideal approach in managing patients with hyperglycemic crisis, but it is not judicious to be applied in
more » ... g countries where shortage of personal protective equipment (PPE) is a major issue. Furthermore, increasing the probability of "already greater risks" for doctors or other healthcare workers contracting COVID-19 seems inappropriate. Thus, an alternative administration strategy and more moderate glucose monitoring to reduce the contact exposure of healthcare workers with COVID-19 patients, by ensuring appropriate blood glucose levels, needs to be performed in this critical pandemic era. Subcutaneous (SC) rapid-acting insulin analog administration could presumably be a solution to this contentious issue.
doi:10.1016/j.dsx.2020.06.032 pmid:32599534 pmcid:PMC7301814 fatcat:kkvv3qxgwfgs3f2phowuikvvvm