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Covid-19 and T2 Diabetes Mellitus (T2DM): a Dangerous Association

XX Congresso Regionale FADOI CAMPANIA: Non ci siamo mai fermati
Italy 2021

Maffettone A, Rossi F, Di Sarno A, d’Errico T, Italiano G, Scarano F, Parrella R, Fiorentino G, Esposito V, Sangiovanni V and Di Fraia S

UOC Medicina Cardiovascolare e Dismetabolica AO Ospedali dei Colli, Napoli, Italy
UOC Mal. Infettive Ad Indirizzo Respiratorio, AO Ospedali dei Colli, Napoli, Italy
UOC Fisiopatologia E Riabilitaz. Respiratoria, AO Ospedali dei Colli, Napoli, Italy
UOC Mal. Infettive E Medicina Di Genere, AO Ospedali dei Colli, Napoli, Italy
UOC Mal. Infettive E Dell'immunodepresso, AO Ospedali dei Colli, Napoli, Italy
Ambulatorio e DH Di Reumatologia PSI Napoli Est, Asl Napoli 1 Centro, Italy
UOC di Medicina Interna, Azienda Ospedaliera S.Anna e San Sebastiano, Caserta, Italy

Posters & Accepted Abstracts: Health Sci J

Abstract:

Background and Aims: During November 2020 through february 2021 we evaluated how the therapies used in treating Covid-19 patients affected blood glucose control in those with both COVID-19 and T2DM. Materials and Methods: We evaluated 432 inpatients affected with Covid-19 pneumonia and T2DM. 337 were male (78%) and 95 female (22%) with age 70 ± 5 yrs and a HbA1c 9 ± 0.7%. Their at home diabetic therapy, along with antibiotic and steroid therapy was always switched to a basal bolus insulin regimen. Results: The T2DM and Covid-19 in-patients had a BMI 28 ± 3 kg/sm and an average of total insulin daily dosage (TDD) at hospitalization of 54 ± 7 IU/day and at discharge of 77 ± 8 IU/day. At hospitalization we performed an i.v insulin infusion protocol to achieve normal blood glucose values that lasted 48 hrs in 195 pts (45%). The switch to basal bolus insulin therapy was made on the 3rd day of hospitalization. The major amount of insulin was administered before lunch and supper (both covering 40% of TDD) with 20% of TDD at night as basal. The major cause of this increase (40%) of TDD is in part due to the inflammatory state and partly to steroid therapy. We didn’t detect any hypoglycemia. Conclusions: We used an enormous amount of insulin, both iv and on basal bolus regimen to achieve a slightly sufficient blood glucose control. Further evaluation in the use of other antihyperglycemic drugs combined to insulin regimen seems appropriate and necessary.