Login Register Cart 0
Generic placeholder image

Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

A Multi-professional Approach for Transition of Care at Discharge in Hyperglycemic Inpatients with COVID-19: A Single Center Study

Author(s): Elena Castellano*, Donatella Gaviglio, Micaela Pellegrino, Laura Gianotti, Giampaolo Magro, Francesco Tassone, Claudia Baffoni, Renza Sibbono, Roberto Attanasio, Alberto Boriano and Giorgio Borretta

Volume 22, Issue 13, 2022

Published on: 06 April, 2022

Page: [1313 - 1318] Pages: 6

DOI: 10.2174/1871530322666220104100944

Price: $65

conference banner
Abstract

Background: The discharge from the hospital of insulin-treated hyperglycemic patients is always challenging. This is even more so in patients requiring glucocorticoid treatment, such as those with COVID-19.

Patients and Methods: A retrospective monocentric study of 23 inpatients was conducted with newly diagnosed or already known diabetes mellitus (DM) who were naïve to insulin treatment, and who were hospitalized with COVID-19 in non-critical settings and then discharged. Patients were followed up for one month after discharge for the management of insulin treatment by a multi-professional team through phone consultations.

Results: Insulin prescriptions at discharge were 24.6 ± 14 U/day injected in 2 ± 1.5 daily shots. A mean of three phone consultations was required. One month later, the mean insulin reduction was 1.5 ± 1.3 shots and 6 ± 5 U/day. All patients reached their glycemic target without hypoglycemic events, drop-outs, or readmissions.

Conclusion: This study demonstrates the feasibility, efficacy, and safety of a multi-professional approach through telemedicine for managing DM patients after discharge during COVID-19.

Keywords: Diabetes, COVID-19, telemedicine, insulin requirement, discharge, inpatients.

« Previous Next »
Graphical Abstract

[1]
Umpierrez, G.E.; Isaacs, S.D.; Bazargan, N.; You, X.; Thaler, L.M.; Kitabchi, A.E. Hyperglycemia: An independent marker of in-hospital mortality in patients with undiagnosed diabetes. J. Clin. Endocrinol. Metab., 2002, 87(3), 978-982.
[http://dx.doi.org/10.1210/jcem.87.3.8341] [PMID: 11889147]
[2]
Zapatero, A.; Gómez-Huelgas, R.; González, N.; Canora, J.; Asenjo, A.; Hinojosa, J.; Plaza, S.; Marco, J.; Barba, R. Frequency of hypoglycemia and its impact on length of stay, mortality, and short-term readmission in patients with diabetes hospitalized in internal medicine wards. Endocr. Pract., 2014, 20(9), 870-875.
[http://dx.doi.org/10.4158/EP14006.OR] [PMID: 24641928]
[3]
Donihi, A.C.; Gibson, J.M.; Noschese, M.L.; DiNardo, M.M.; Koerbel, G.L.; Curll, M.; Korytkowski, M.T. Effect of a targeted glycemic management program on provider response to inpatient hyperglycemia. Endocr. Pract., 2011, 17(4), 552-557.
[http://dx.doi.org/10.4158/EP10330.OR] [PMID: 21454237]
[4]
Caballero, A.E.; Ceriello, A.; Misra, A.; Aschner, P.; McDonnell, M.E.; Hassanein, M.; Ji, L.; Mbanya, J.C.; Fonseca, V.A. COVID-19 in people living with diabetes: An international consensus. J. Diabetes Complications, 2020, 34(9), 107671.
[http://dx.doi.org/10.1016/j.jdiacomp.2020.107671] [PMID: 32651031]
[5]
Zhou, F.; Yu, T.; Du, R.; Fan, G.; Liu, Y.; Liu, Z.; Xiang, J.; Wang, Y.; Song, B.; Gu, X.; Guan, L.; Wei, Y.; Li, H.; Wu, X.; Xu, J.; Tu, S.; Zhang, Y.; Chen, H.; Cao, B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet, 2020, 395(10229), 1054-1062.
[http://dx.doi.org/10.1016/S0140-6736(20)30566-3] [PMID: 32171076]
[6]
American Diabetes Association. 15. Diabetes care in the hospital: Standards of medical care in diabetes-2020. Diabetes Care, 2020, 43(Suppl. 1), S193-S202.
[http://dx.doi.org/10.2337/dc20-S015] [PMID: 31862758]
[7]
Sanders, J.M.; Monogue, M.L.; Jodlowski, T.Z.; Cutrell, J.B. Pharmacologic treatments for coronavirus disease 2019 (COVID-19): A review. JAMA, 2020, 323(18), 1824-1836.
[http://dx.doi.org/10.1001/jama.2020.6019] [PMID: 32282022]
[8]
Angelidi, A.M.; Belanger, M.J.; Mantzoros, C.S. Commentary: COVID-19 and diabetes mellitus: What we know, how our patients should be treated now, and what should happen next. Metabolism, 2020, 107, 154245.
[http://dx.doi.org/10.1016/j.metabol.2020.154245] [PMID: 32320742]
[9]
American Diabetes Association. 12. Older adults: Standards of medical care in diabetes-2021. Diabetes Care, 2021, 44(Suppl. 1), S168-S179.
[http://dx.doi.org/10.2337/dc21-S012] [PMID: 33298423]
[10]
2. Classification and diagnosis of diabetes: Standards of medical care in diabetes-2021. Diabetes Care, 2021, 44(Suppl. 1), S15-S33.
[http://dx.doi.org/10.2337/dc21-S002] [PMID: 33298413]
[11]
National Kidney Foundation. K/DOQ 350 I clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Am. J. Kidney Dis., 2002, 39(2 Suppl 352 1), S1-266.
[12]
Scheen, A.J.; Marre, M.; Thivolet, C. Prognostic factors in patients with diabetes hospitalized for COVID-19: Findings from the CORONADO study and other recent reports. Diabetes Metab., 2020, 46(4), 265-271.
[http://dx.doi.org/10.1016/j.diabet.2020.05.008] [PMID: 32447101]
[13]
Fadini, G.P.; Morieri, M.L.; Longato, E.; Avogaro, A. Prevalence and impact of diabetes among people infected with SARS-CoV-2. J. Endocrinol. Invest., 2020, 43(6), 867-869.
[http://dx.doi.org/10.1007/s40618-020-01236-2] [PMID: 32222956]
[14]
Li, B.; Yang, J.; Zhao, F.; Zhi, L.; Wang, X.; Liu, L.; Bi, Z.; Zhao, Y. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin. Res. Cardiol., 2020, 109(5), 531-538.
[http://dx.doi.org/10.1007/s00392-020-01626-9] [PMID: 32161990]
[15]
Roncon, L.; Zuin, M.; Rigatelli, G.; Zuliani, G. Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome. J. Clin. Virol., 2020, 127, 104354.
[http://dx.doi.org/10.1016/j.jcv.2020.104354] [PMID: 32305882]
[16]
Apicella, M.; Campopiano, M.C.; Mantuano, M.; Mazoni, L.; Coppelli, A.; Del Prato, S. COVID-19 in people with diabetes: Understanding the reasons for worse outcomes. Lancet Diabetes Endocrinol., 2020, 8(9), 782-792.
[http://dx.doi.org/10.1016/S2213-8587(20)30238-2] [PMID: 32687793]
[17]
Muniyappa, R.; Gubbi, S. COVID-19 pandemic, coronaviruses, and diabetes mellitus. Am. J. Physiol. Endocrinol. Metab., 2020, 318(5), E736-E741.
[http://dx.doi.org/10.1152/ajpendo.00124.2020] [PMID: 32228322]
[18]
Lim, S.; Bae, J.H.; Kwon, H.S.; Nauck, M.A. COVID-19 and diabetes mellitus: From pathophysiology to clinical management. Nat. Rev. Endocrinol., 2021, 17(1), 11-30.
[http://dx.doi.org/10.1038/s41574-020-00435-4] [PMID: 33188364]
[19]
Dhatariya, K.; Corsino, L.; Umpierrez, G.E. MDText.com, Inc.: South Dartmouth (MA), 2000. Management of diabetes and hyperglycemia in hospitalized patients. MDText.com, Inc.: South Dartmouth (MA), , 2000.
[20]
Scherholz, M.L.; Schlesinger, N.; Androulakis, I.P. Chronopharmacology of glucocorticoids. Adv. Drug Deliv. Rev., 2019, 151-152, 245-261.
[http://dx.doi.org/10.1016/j.addr.2019.02.004] [PMID: 30797955]
[21]
Shepperd, S.; Lannin, N.A.; Clemson, L.M.; McCluskey, A.; Cameron, I.D.; Barras, S.L. Discharge planning from hospital to home. Cochrane Database Syst. Rev., 2013, (1), CD000313.
[PMID: 23440778]
[22]
Rushakoff, R.J.; Sullivan, M.M.; MacMaster, H.W.; Shah, A.D.; Rajkomar, A.; Glidden, D.V.; Kohn, M.A. Association between a virtual glucose management service and glycemic control in hospitalized adult patients: an observational study. Ann. Intern. Med., 2017, 166(9), 621-627.
[http://dx.doi.org/10.7326/M16-1413] [PMID: 28346946]
[23]
Torlone, E.; Festa, C.; Formoso, G.; Scavini, M.; Sculli, M.A.; Succurro, E.; Sciacca, L.; Di Bartolo, P.; Purrello, F.; Lapolla, A. Italian recommendations for the diagnosis of gestational diabetes during COVID-19 pandemic: Position statement of the Italian Association of Clinical Diabetologists (AMD) and the Italian Diabetes Society (SID), diabetes, and pregnancy study group. Nutr. Metab. Cardiovasc. Dis., 2020, 30(9), 1418-1422.
[http://dx.doi.org/10.1016/j.numecd.2020.05.023] [PMID: 32675009]
[24]
d’Annunzio, G.; Maffeis, C.; Cherubini, V.; Rabbone, I.; Scaramuzza, A.; Schiaffini, R.; Minuto, N.; Piccolo, G.; Maghnie, M. Caring for children and adolescents with type 1 diabetes mellitus: Italian Society for Pediatric Endocrinology and Diabetology (ISPED) statements during COVID-19 pandemia. Diabetes Res. Clin. Pract., 2020, 168, 108372.
[http://dx.doi.org/10.1016/j.diabres.2020.108372] [PMID: 32827594]
[25]
Bornstein, S.R.; Rubino, F.; Khunti, K.; Mingrone, G.; Hopkins, D.; Birkenfeld, A.L.; Boehm, B.; Amiel, S.; Holt, R.I.; Skyler, J.S.; DeVries, J.H.; Renard, E.; Eckel, R.H.; Zimmet, P.; Alberti, K.G.; Vidal, J.; Geloneze, B.; Chan, J.C.; Ji, L.; Ludwig, B. Practical recommendations for the management of diabetes in patients with COVID-19. Lancet Diabetes Endocrinol., 2020, 8(6), 546-550.
[http://dx.doi.org/10.1016/S2213-8587(20)30152-2] [PMID: 32334646]

Rights & Permissions Print Cite
Article Metrics
27
3
Wayfinder Image
© 2024 Bentham Science Publishers | Privacy Policy