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@#BACKGROUND AND OBJECTIVES. Several reports have shown that coexistence of diabetes mellitus and COVID-19 is one of the risk factors for poor outcome and increased mortality. Rapid metabolic deterioration with development of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar syndrome (HHS) may result due to the acute insulin secretory capacity loss, stress condition and the cytokine storm. In this review, we aim to describe the prevalence of hyperglycemic crises(DKA/HHS) in patients with COVID-19 infection as well as their clinical outcomes. METHODS. An intensive search was done using the WebMD, PubMed, Medline and Google Scholar databases for articles published between December 2019 to October 2020 that identified the number of patients who developed DKA and/or HHS among those who were admitted for COVID-19. Their clinical outcomes were likewise described. RESULTS. This review included 4 articles in which individual quality was assessed. A total of 1282 patients were admitted for COVID-19 and the prevalence of DKA was 1.32%. HHS was not reported in any of the studies. Five (29.4%) of the patients with DKA and COVID-19 died and 12 (70.6%) recovered. CONCLUSIONS. A significant number of COVID-19 patients developed DKA and it is associated with a high mortality rate. This reimposes the need for an appropriate algorithm for the optimal management of concomitant COVID 19 and hyperglycemic crises to avoid morbidity and mortality. Additionally, there is paucity of large-scale studies describing the prevalence of DKA/HHS in patients with COVID-19.
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Diabetic Ketoacidosis , COVID-19 , Water-Electrolyte Imbalance , Acid-Base Imbalance , ComaABSTRACT
Objective To compare the effect of insulin instiling and CSII in treatment of DKA and DHS Methods Patients with DKA (n=40) and DNHS (n=40)were chosen for comparing the effect between intravenous insulin instilling treatment and CSII therapy Results Both CSII and insulin instilling controlled effectively DKA and DHS,but the former surpassed the latter in the therapeutic respects of insulin dosage,hypoglycemic speed,glycemic stability,ketobody clearance.Conclusion CSII has an advantage over insulin instilling
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Objective To determine the occurrence of rhabdomyolysis(RM) in the diabetic hyperosmolar hyperglycemic state.Methods Sixteen patients(9 men and 7 women) with diabetic hyperosmolar state were studied.Six of 16(37.50%) patients showed biochemical evidence of RM.The clinical and biochemical features of the patients with RM(group RM) and the patients without RM(group non-RM) were compared.Results Patients with RM showed a 30-fold increase in serum creatine phospholipase(CK) and 50-fold in myoglobin (Mb) when compared to the patients without RM.Significantly higher mean glucose level,serum sodium level and serum osmolality were found in patients with RM than in those without RM(P