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Hypoglycemia at the time of Covid-19 pandemic.
Shah, Kiran; Tiwaskar, Mangesh; Chawla, Purvi; Kale, Mayura; Deshmane, Rajesh; Sowani, Alpana.
  • Shah K; Diabetes & Thyroid Care Center, India. Electronic address: drkiranshh@gmail.com.
  • Tiwaskar M; Shilpa Medical Research Centre, India. Electronic address: tiwaskar@gmail.com.
  • Chawla P; Lina Diabetes Care and Mumbai Diabetes Research Centre, India. Electronic address: purvi_chawla@yahoo.com.
  • Kale M; Dr Kale's Diabetes and Psychiatry Clinic, India. Electronic address: kalediabetesclinic@gmail.com.
  • Deshmane R; Shree Mahalaxmi Diabetic Care Centre, India. Electronic address: smdcc_kolhapur@yahoo.com.
  • Sowani A; Diabetes Specialty Centre, India. Electronic address: alpanasowani@gmail.com.
Diabetes Metab Syndr ; 14(5): 1143-1146, 2020.
Article in English | MEDLINE | ID: covidwho-642952
ABSTRACT

BACKGROUND:

Hypoglycemia is the limiting factor in the glycemic management of diabetes, which need to be addressed critically to avoid complications. Lockdown because of new coronavirus strain (COVID-19) pandemic has further complicated the issue of hypoglycemia due to limitations in access to food, outpatient clinics, pathological services and medicines.

AIM:

To assess the factors associated with the risk of hypoglycemia during April-May 2020 lockdown in people with type 2 diabetes mellitus.

METHODOLOGY:

We analyzed the data retrospectively from 146 patients of type 2 diabetes mellitus (T2DM) reporting to the emergency department (ED) during lockdown period with symptoms suggestive of hypoglycemia.

RESULTS:

The majority of patients were male (90/146) with a mean age of 59.88 ± 10.09 years and a mean random blood glucose level of 57.67 ± 9.00 mg/dL. Two-third of patients (70.83%) had level 1 hypoglycemia, while level 2 hypoglycemia was reported in 29.16% of patients. A combination of Metformin and Sulfonylureas (SU) was most commonly associated with the risk of hypoglycemia (65.75%) followed by insulin (33.56%). Subjects who received insulin reported a lower blood glucose value (50.75 ± 8.20 mg/dL) as compared to those receiving a combination of metformin and SU (60.95 ± 7.10 mg/dl). 330.56% of patients who had received prophylaxis hydroxychloroquine (HCQ) 400 mg twice a day along with the routine anti-hyperglycemic agents without their dose adjustment reported hypoglycemia. Patients with hypertension, micro-vascular, macro-vascular complications, and coexistent with each other had a higher propensity to the risk of hypoglycemia (46.58%, 33.56%, 23.29%, and 32.88%) respectively.

CONCLUSION:

The COVID-19 lockdown has shown to influence the risk of hypoglycemia in patients with T2DM, especially those receiving SU, insulin, HCQ especially in patients with associated co-morbidities. Patient education, support, and telemedicine plays a pivotal role to prevent hypoglycemia.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Diabetes Mellitus, Type 2 / Betacoronavirus / Hypoglycemia Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Diabetes Metab Syndr Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Diabetes Mellitus, Type 2 / Betacoronavirus / Hypoglycemia Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Diabetes Metab Syndr Year: 2020 Document Type: Article