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Issues for the management of people with diabetes and COVID-19 in ICU.
Ceriello, Antonio; Standl, Eberhard; Catrinoiu, Doina; Itzhak, Baruch; Lalic, Nebojsa M; Rahelic, Dario; Schnell, Oliver; Skrha, Jan; Valensi, Paul.
  • Ceriello A; IRCCS MultiMedica, Via Gaudenzio Fantoli, 16/15, 20138, Milan, Italy. antonio.ceriello@hotmail.it.
  • Standl E; Forschergruppe Diabetes e.V. at Munich Helmholtz Centre, Munich, Germany.
  • Catrinoiu D; Clinical Center of Diabetes, Nutrition and Metabolic Diseases, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania.
  • Itzhak B; Clalit Health Services and Technion Faculty of Medicine, Haifa, Israel.
  • Lalic NM; Clinic for Endocrinology, Diabetes and Metabolic Diseases, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
  • Rahelic D; Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia.
  • Schnell O; University of Zagreb School of Medicine, Zagreb, Croatia.
  • Skrha J; University of Osijek School of Medicine, Osijek, Croatia.
  • Valensi P; Forschergruppe Diabetes e.V. at Munich Helmholtz Centre, Munich, Germany.
Cardiovasc Diabetol ; 19(1): 114, 2020 07 20.
Article in English | MEDLINE | ID: covidwho-656673
Semantic information from SemMedBD (by NLM)
1. Diabetes PROCESS_OF Persons
Subject
Diabetes
Predicate
PROCESS_OF
Object
Persons
2. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Persons
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Persons
3. Present COEXISTS_WITH COVID-19
Subject
Present
Predicate
COEXISTS_WITH
Object
COVID-19
4. Intravenous infusion procedures USES Insulin
Subject
Intravenous infusion procedures
Predicate
USES
Object
Insulin
5. Hydroxymethylglutaryl-CoA Reductase Inhibitors STIMULATES angiotensin converting enzyme 2
Subject
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Predicate
STIMULATES
Object
angiotensin converting enzyme 2
6. Problem COEXISTS_WITH COVID-19
Subject
Problem
Predicate
COEXISTS_WITH
Object
COVID-19
7. Troponin AUGMENTS Diabetes
Subject
Troponin
Predicate
AUGMENTS
Object
Diabetes
8. Fibrin fragment D AUGMENTS Diabetes
Subject
Fibrin fragment D
Predicate
AUGMENTS
Object
Diabetes
9. Diabetes PROCESS_OF Persons
Subject
Diabetes
Predicate
PROCESS_OF
Object
Persons
10. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Persons
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Persons
11. Present COEXISTS_WITH COVID-19
Subject
Present
Predicate
COEXISTS_WITH
Object
COVID-19
12. Intravenous infusion procedures USES Insulin
Subject
Intravenous infusion procedures
Predicate
USES
Object
Insulin
13. Hydroxymethylglutaryl-CoA Reductase Inhibitors STIMULATES angiotensin converting enzyme 2
Subject
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Predicate
STIMULATES
Object
angiotensin converting enzyme 2
14. Problem COEXISTS_WITH COVID-19
Subject
Problem
Predicate
COEXISTS_WITH
Object
COVID-19
15. Troponin AUGMENTS Diabetes
Subject
Troponin
Predicate
AUGMENTS
Object
Diabetes
16. Fibrin fragment D AUGMENTS Diabetes
Subject
Fibrin fragment D
Predicate
AUGMENTS
Object
Diabetes
ABSTRACT
In the pandemic "Corona Virus Disease 2019" (COVID-19) people with diabetes have a high risk to require ICU admission. The management of diabetes in Intensive Care Unit is always challenging, however, when diabetes is present in COVID-19 the situation seems even more complicated. An optimal glycemic control, avoiding acute hyperglycemia, hypoglycemia and glycemic variability may significantly improve the outcome. In this case, intravenous insulin infusion with continuous glucose monitoring should be the choice. No evidence suggests stopping angiotensin-converting-enzyme inhibitors, angiotensin-renin-blockers or statins, even it has been suggested that they may increase the expression of Angiotensin-Converting-Enzyme-2 (ACE2) receptor, which is used by "Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to penetrate into the cells. A real issue is the usefulness of several biomarkers, which have been suggested to be measured during the COVID-19. N-Terminal-pro-Brain Natriuretic-Peptide, D-dimer and hs-Troponin are often increased in diabetes. Their meaning in the case of diabetes and COVID-19 should be therefore very carefully evaluated. Even though we understand that in such a critical situation some of these requests are not so easy to implement, we believe that the best possible action to prevent a worse outcome is essential in any medical act.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Blood Glucose / Coronavirus Infections / Diabetes Mellitus / Betacoronavirus / Hypoglycemic Agents / Intensive Care Units Type of study: Diagnostic study / Etiology study / Observational study / Risk factors Limits: Humans Language: English Journal: Cardiovasc Diabetol Journal subject: Vascular Diseases / Cardiology / Endocrinology Year: 2020 Document Type: Article Affiliation country: S12933-020-01089-2

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Blood Glucose / Coronavirus Infections / Diabetes Mellitus / Betacoronavirus / Hypoglycemic Agents / Intensive Care Units Type of study: Diagnostic study / Etiology study / Observational study / Risk factors Limits: Humans Language: English Journal: Cardiovasc Diabetol Journal subject: Vascular Diseases / Cardiology / Endocrinology Year: 2020 Document Type: Article Affiliation country: S12933-020-01089-2