Table 1 Clinical recommendations for management of diabetes during COVID-19 pandemic (modified from Bornstein et al. [64])

Outpatient/community

Prevent infection

Educate patients about importance of glycaemic control

Optimise current management

Do not discontinue existing therapy

Use Connected Health to maintain contact with patient

Optimise glycaemic control

Aim for plasma glucose of 4–8 mmol/L and HbA_1c < 53 mmol/mol (7%)

Hypoglycaemic (< 3.9 mmol/L) less than 4% (< 1% in frail/elderly)

Encourage moderately intense physical activity

In-patient/ ICU

Monitor for new onset of diabetes

Plasma glucose monitoring

Measure venous blood pH

Check blood ketones

Manage infected patients

Low threshold for early IV insulin in severe cases (e.g. ARDS)

Achieve glycaemic control

Aim for plasma glucose of 4–10 mmol/L