Diabetes, Metabolic Syndrome and Obesity (May 2021)

Bangladesh Endocrine Society (BES) Position Statement for Management of Diabetes and Other Endocrine Diseases in Patients with COVID-19

  • Pathan F,
  • Selim S,
  • Fariduddin M,
  • Rahman MH,
  • Ashrafuzzaman SM,
  • Afsana F,
  • Qureshi NK,
  • Hossain T,
  • Saifuddin M,
  • Kamrul-Hasan AB,
  • Mir AS

Journal volume & issue
Vol. Volume 14
pp. 2217 – 2228

Abstract

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Faruque Pathan,1 Shahjada Selim,2 Md Fariduddin,2 Md Hafizur Rahman,3 SM Ashrafuzzaman,1 Faria Afsana,1 Nazmul Kabir Qureshi,4 Tanjina Hossain,5 M Saifuddin,6 AB Kamrul-Hasan,7 Ahmed Salam Mir8 On behalf of the BES Diabetes and COVID Task Force1Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh; 2Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh; 3Bangladesh Endocrine Society, Dhaka, Bangladesh; 4National Healthcare Network (NHN) Uttara EC, Dhaka, Bangladesh; 5Department of Endocrinology, Green Life Medical College Hospital, Dhaka, Bangladesh; 6Department of Endocrinology, Dhaka Medical College Hospital, Dhaka, Bangladesh; 7Mymensingh Medical College Hospital, Dhaka, Bangladesh; 8Department of Endocrinology, BIHS General Hospital, Dhaka, BangladeshCorrespondence: Shahjada SelimDepartment of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, 1000, BangladeshEmail [email protected]: The year 2020 witnessed a largely unprecedented pandemic of coronavirus disease (COVID-19), caused by SARS COV-2. Many people with COVID-19 have comorbidities, including diabetes, hypertension and cardiovascular diseases, which are significantly associated with worse outcomes. Moreover, COVID-19 itself is allied with deteriorating hyperglycemia. Therefore, Bangladesh Endocrine Society has formulated some practical recommendations for management of diabetes and other endocrine diseases in patients with COVID-19 for use in both primary and specialist care settings.Objective: The objective of the article is to develop a guideline to protect the vulnerable group with utmost preference – the elderly and those with comorbid conditions. Therefore, to ensure the adequate protective measures and timely treatment for COVID-19 patients with diabetes, other endocrine diseases or any other comorbidities.Considering and Monitoring Issues: The risk of a fatal outcome from COVID-19 may be up to 50% higher in patients with diabetes than in non-diabetics.Patients with diabetes and COVID had CFR 7.3– 9.2%, compared with 0.9– 1.4% in patients without comorbidities.Diabetic ketoacidosis may be one of the causes of mortality in COVID-19.There is wide fluctuation of blood glucose in these patients, probably due to irregular diet, reduced exercise, increased glucocorticoids secretion, and use of glucocorticoids.HbA1c should be < 7.0% for the majority of the patients, this target may be relaxed in appropriate clinical settings.More emphasis should be given on day-to-day blood glucose levels. Hypoglycemia (< 3.9 mmol/l) must be avoided.Frequent monitoring of blood glucose is needed in critically ill patients.Conclusion: The fight against COVID-19 has been proven to be a challenging one. Therefore, all healthcare personnel should make the best use of updated knowledge and skills to ensure adequate protective measures and timely treatment for COVID-19 patients with diabetes, other endocrine diseases or any other comorbidities.Keywords: COVID-19, diabetes mellitus, SARS COV-2, antidiabetic medications, endocrine diseases and COVID-19, thyroid disease and COVID-19

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