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

From: COVID-19 in adult patients with pre-existing chronic cardiac, respiratory and metabolic disease: a critical literature review with clinical recommendations

Clinical Setting Therapeutic Goal Recommendations
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 HbA1c < 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
  1. ICU Intensive care unit, IV Intravenous, ARDS Acute respiratory distress syndrome