COVID-19 DIABETES MANAGEMENT GUIDELINES FOR PREVENTION AND
TREATMENT OF MUCORMYCOSIS
1. Regular blood sugar monitoring should be done for all diabetic patient sunder Home Quarantine, COVID Care Centre, COVID Health Centre, Primary Health Centre and COVID Hospitals.
2. Even Non-Diabetic patients may show increase in blood sugar after 3rd dayof steroids. Hence blood sugar should be monitored for them too, including pre dinner blood sugar levels.
3. OHA's can be continued for patients who do not have hypoxia or organ dysfunction. Insulin should be added if adequate control is not achieved with OHA's.
4. Insulin should be initiated in all patients on steroids with oxygen support.
5. The regimen should include 3 doses of short acting insulin before break fast, lunch and dinner & morning and night basal insulin. 6. Patients on steroids may require higher dose of Insulin at 1 to 2 units/ kg body weight per day.
7. As and when steroid therapy is modified, insulin dose should be modified accordingly.
8. Patient with poor oral intake require RT feeding/ IV dextrose containing fluids if they are on subcutaneous insulin.
9. If fasting blood sugar is >400 mgs/dl (or) RBS > 500 mgs/dl, insulin infusion should be started at a rate of 5 units/hr. [Kindly add 25 units ofregular insulin in 500ml of NS and flow at 100 ml/hr. Hourly CBG monitoring should be done till blood sugar drops to 200mgs/di]. There after subcutaneous insulin should be given depending onpatient's oral intake. All patients started on insulin infusion should be monitored for serum potassium levels.
10. Patients should be monitored for both hypoglycemia and hypokalemia.
J.RADHAKRISHNAN,
PRINCIPAL SECRETARY TO GOVERNMENT
It affects women during pregnancy. It usually affects 3 to 8 % of pregnant women. Women are at a risk of developing Type 2 Diabetes later in life if they had Gestational diabetes during pregnancy.Gestational diabetes should be monitored and controlled to reduce risk.
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