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The Effect of GLP1-RA/Basal Insulin vs. Basal Bolus Insulin Therapy in Type 2 Diabetes Inpatients Affected by COVID-19 Pneumonia

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

Maffettone A, d’Errico T, Italiano G, Rinaldi M, Maiolica O and Di Fraia S

UOC Medicina Cardiovascolare e Dismetabolica, 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
Ex UOD Unita' Metabolica, AO Ospedali dei Colli, Napoli, Italy

Posters & Accepted Abstracts: Health Sci J

Abstract:

Background: During the Covid-19 pandemic in type 2 diabetic inpatients (T2DM pts) of our Medicine wards we administered enormous amounts of s.c. insulin through the basal bolus regimen aiming at obtaining a good metabolic control, often difficult to reach both for the septic state and steroid therapy of our diabetic inpatients. Materials and Methods: Often we administered almost 60 to 80 units/insulin per day (TDD) per patient, not obtaining a good metabolic control; we decided to switch some of our in-patients treated with basal bolus insulin regimen to boluses plus a fixed ratio combination of GLP1-RA/basal insulin trying to exploit both the antiinflammatory and slimming effect of GLP1-RA. Results: We evaluated between october and december 2020 54 T2DM in-patients with Covid-19 pneumonia. They were 41 Males and 13 Female aged 70 ± 5 yrs, BMI 31 ± 3 kg/sm with an average HbA1c 8.3 ± 1.2 and an insulin TDD of 70 ± 11 s.c. compared to 40 matched (for sex, age, BMI and insulin TDD) “control” pts treated with basal bolus regimen. Conclusions: We detected in the fixed ratio combination of GLP1- RA/basal insulin a faster and stable good metabolic control vs. the basal bolus treated pts. We reduced the average amount of insulin TDD of 34% with great satisfaction of pts and health care personnel.