This information is sourced from Diabetes UK, a Primary Care Diabetes Society (PCDS) factsheet and PCDS update:

• There is an increased risk of metabolic decompensation in people with diabetes during Covid-19 infection
• Capillary glucose and urinary ketone levels should be checked in people acutely unwell with suspected Covid-19
• Advise patients how to follow the SICK rules for managing intercurrent illness
  • Insulin therapy should never be stopped during intercurrent illness
  • Patients should stop taking SGLT2i tablets if they become unwell with Covid-19 because of the increased risk of DKA
  • Metformin may warrant temporary suspension during the acute illness phase
  • Oral therapies can usually be re-started once the acute phase has passed and the individual is eating and drinking again
• Consider supporting people with diabetes with home oximetry even if <65 yrs and not CEV
• Be aware of the risk of euglycemic DKA during acute intercurrent illness in people prescribed SGLT2 inhibitors, even in the presence of relatively normal blood glucose levels
• Some people with diabetes may be discharged from hospital on higher doses or additional glucose-lowering therapies, including insulin, that may need adjustment in subsequent days or weeks

Useful resources:

• There is a very clear algorithm on the PCDS factsheet for managing dosing of rapid-acting insulin
• Diabetes UK provide helpful information for patients on how to identify and manage hyperglycaemia and hypoglycaemia