Subject(s)
COVID-19 Drug Treatment , Dexamethasone/administration & dosage , Diabetes Mellitus/drug therapy , Diabetes Mellitus/epidemiology , Glycemic Control/methods , SARS-CoV-2 , COVID-19/epidemiology , Comorbidity , Dexamethasone/adverse effects , Humans , Hypoglycemia/chemically induced , Hypoglycemia/prevention & control , Insulin, Isophane/administration & dosageABSTRACT
The National Diabetes Stakeholders Covid-19 Response Group was formed in early April 2020 as a rapid action by the Joint British Diabetes Societies for Inpatient Care, Diabetes UK, the Association of British Clinical Diabetologists, and Diabetes Frail to address and support the special needs of residents with diabetes in UK care homes during Covid-19. It was obvious that the care home sector was becoming a second wave of Covid-19 infection and that those with diabetes residing in care homes were at increased risk not only of susceptibility to infection but also to poorer outcomes. Its key purposes included minimising the morbidity and mortality associated with Covid-19 and assisting care staff to identify those residents with diabetes at highest risk of Covid-19 infection. The guidance was particularly created for care home managers, other care home staff, and specialist and non-specialist community nursing teams. The guidance covers the management of hyperglycaemia by discussion of various clinical scenarios that could arise, the management of hypoglycaemia, foot care and end of life care. In addition, it outlines the conditions where hospital admission is required. The guidance should be regarded as interim and will be updated as further medical and scientific evidence becomes available.
Subject(s)
Coronavirus Infections/therapy , Delivery of Health Care/methods , Diabetes Mellitus/therapy , Nursing Homes , Pneumonia, Viral/therapy , Betacoronavirus , COVID-19 , Comorbidity , Coronavirus Infections/epidemiology , Coronavirus Infections/metabolism , Diabetes Complications/epidemiology , Diabetes Mellitus/epidemiology , Disease Management , Frailty , Glucocorticoids/therapeutic use , Humans , Life Expectancy , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/metabolism , Risk Factors , SARS-CoV-2 , United Kingdom/epidemiologyABSTRACT
The UK National Diabetes Inpatient COVID Response Group was formed at the end of March 2020 to support the provision of diabetes inpatient care during the COVID pandemic. It was formed in response to two emerging needs. First to ensure that basic diabetes services are secured and maintained at a time when there was a call for re-deployment to support the need for general medical expertise across secondary care services. The second was to provide simple safe diabetes guidelines for use by specialists and non-specialists treating inpatients with or suspected of COVID-19 infection. To date the group, comprising UK-based specialists in diabetes, pharmacy and psychology, have produced two sets of guidelines which will be continually revised as new evidence emerges. It is supported by Diabetes UK, the Association of British Clinical Diabetologists and NHS England.