Hyperglycemia management

Good morning,

Anyone out there seeing severe glucose derangements in their COVID patients? I hate initiating insulin drips because of increased nursing exposure, but I can’t make any ground with basal/bolus therapy.


Yes we are.

Our sugar control protocol involves 3 measures

  1. Insulin SSI
  2. Fixed dosing of insulin q6h
  3. Lantus q24h vs NPH q12h

If this does not work then we get endocrine involved who pretty much tinker around with the above fornula till we get some sort of control. Best of luck

P.s.- Had to initiate insulin only on one patient till date due to very erratic sugars

We have had to use insulin drips mostly on patients with known diabetes. The patients without pre-COVID diabetes we have been able to manage with subcutaneous insulin both ISS and medium to long acting. We have tried our best to keep the blood sugars between 160-180.

It would make sense of pancreatic dysfunction. The main problem from Covid is coagulation in the vessels, seen clogging up lungs and kidneys causing failure of those organs prompting ventilator support or dialysis.

We have also seen some patients develop mild cases of pancreatitis as evidence by either elevated enzymes or even radiologic evidence of pancreatitis. I am assuming this is also due to micro vascular thrombosis in the pancreas itself.

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