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Covid-19 Primary Care Resources

Covid-19 infection in people with diabetes

Diabetes prescribing

Specific advice for diabetic patients unwell with Covid-19

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

Key points:

  • 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