Updated May 1, 2020
- This section is in development
- Hyperglycemia, DKA with concomitant increased insulin requirements are common in critically ill patients with COVID-19.
- In an effort to minimize the number of patients on insulin infusions, the Diabetes Subcommittee has developed a guideline for COVID-19 patients who are critically ill and/or in mild-moderate DKA to allow for q 4h monitoring and SC insulin dosing.
- This strategy will minimize exposure with RN time at bedside and conserve PPE while maintaining the ability to deliver high dose insulin therapy distributed across multiple adjustable doses per day.
- The major difference to highlight is the change to a q 4h interval (as compared to the q 1h monitoring and insulin dosing with BHIP and q 2h with the SC DKA protocol). This guideline also expands the use of a SC DKA protocol to include both mild and moderate DKA and with this in place only severe DKA/HHS will require an insulin infusion.
- Guidelines on COVID-specific DKA and Hyperglycemia Insulin treatment are available here
- Additional glucose and insulin management assistance is available by paging Endocrine (p11519) or Diabetes (p34444) Consultation. They can assist with:
- Adjustment of Insulin Orders and Hypoglycemia Prevention
- Insulin Management during Transition of Care Planning