Open AccessHyperglycaemia in COVID-19: improving recognition and management in a single centre
Author(s) -
Jordan Wardrope,
Iona Elizabeth McKenzie,
N. J. Barwell
Publication year - 2021
Publication title -
the british journal of diabetes
Language(s) - English
Resource type - Journals
eISSN - 2397-6241
pISSN - 2397-6233
DOI - 10.15277/bjd.2021.324
Subject(s) - medicine , guideline , psychological intervention , diabetes mellitus , covid-19 , intensive care medicine , emergency medicine , disease , disease management , intervention (counseling) , nursing , pathology , infectious disease (medical specialty) , endocrinology , parkinson's disease
Background: Hyperglycaemia is a recognised complication of COVID-19 disease and is associated with increased morbidity and mortality. Effects are noted in individuals with and without diabetes and potentiated by the use of recognised COVID-19 treatments such as corticosteroids. Early glycaemic control in the inpatient with COVID-19 disease impacts significantly on outcomes.Methods: A three-phase improvement project evaluated the recognition and management of hyperglycaemia in 120 adult inpatients with COVID-19 disease over a 4-month period. A local guideline and a separate acute care ‘bundle’ were implemented to improve performance. The main outcomes of the project were evaluated in a repeated cross- sectional design; assessing the performance of regular capillary blood glucose monitoring and appropriate treatment of hyperglycaemia where indicated.Results: Prior to intervention, 78.6% of patients had appropriate capillary blood glucose monitoring and no patients were deemed to receive appropriate treatment. Following interventions, 83–100% of patients had appropriate monitoring and 75–100% received appropriate treatment.Conclusions: In this setting, implementation of a guideline and a care bundle contributed towards improved recognition and management of hyperglycaemia in patients with COVID-19 disease. Future study could assess the impact of interventions on a larger scale whilst investigating variation in the subtype of diabetes, patient sex and other demographics on outcomes such as length of stay, morbidity and mortality.