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. 2020 Jun;8(6):546-550.
doi: 10.1016/S2213-8587(20)30152-2. Epub 2020 Apr 23.

Practical Recommendations for the Management of Diabetes in Patients With COVID-19

Free PMC article

Practical Recommendations for the Management of Diabetes in Patients With COVID-19

Stefan R Bornstein et al. Lancet Diabetes Endocrinol. .
Free PMC article


Diabetes is one of the most important comorbidities linked to the severity of all three known human pathogenic coronavirus infections, including severe acute respiratory syndrome coronavirus 2. Patients with diabetes have an increased risk of severe complications including Adult Respiratory Distress Syndrome and multi-organ failure. Depending on the global region, 20-50% of patients in the coronavirus disease 2019 (COVID-19) pandemic had diabetes. Given the importance of the link between COVID-19 and diabetes, we have formed an international panel of experts in the field of diabetes and endocrinology to provide some guidance and practical recommendations for the management of diabetes during the pandemic. We aim to briefly provide insight into potential mechanistic links between the novel coronavirus infection and diabetes, present practical management recommendations, and elaborate on the differential needs of several patient groups.


Flowchart for metabolic screening and type 1 and 2 diabetes management of patients with COVID-19 Older patients refers to those aged 70 and above. ARDS=Acute Respiratory Distress Syndrom. CGM=Continous Glucose Measurement. FGM=Flash Glucose Measurement. HbA1c=haemoglobin A1c. TIR=time in range. *Target concentrations for lower plasma glucose can be adjusted to 5 mmol/l (90 mg/dl) in frail patients. †HbA1c testing might not be possible at the time, but previous measurements if available allow for differentiation of chronic and acute decompensation.

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