ABCD makes DKA and COVID-19 safety recommendations

Healthcare professionals treating people with Diabetic ketoacidosis (DKA) and COVID-19 must consider additional safety concerns, the National Inpatient Diabetes COVID-19 Response Group has warned.

The organisation, supported by ABCD which represents consultant diabetologists has issued guidelines on its website, reminding clinicians that people with type 1 diabetes who are taking SGLT-2 inhibitors (Dapagliflozin, Empagliflozin, Canagliflozin and Ertuglifozin) are at risk of developing DKA during any intercurrent illness.

But, as there is currently a lack of “high-quality evidence ” relating to DKA and COVID-19, the organisation has said that it believes “clinicians may wish to discuss these medications with their patients and possibly mutually agree to stop SGLT-2 inhibitors and control blood glucose by adjusting insulin doses”.

Dr Umesh Dashora said: “We recommend that people with type 1 diabetes should not be initiated on SGLT-2 inhibitors in addition to insulin until [the] COVID epidemic is over.

“People with type 2 diabetes can continue to take SGLT-2 inhibitor drugs unless they become unwell. If they become unwell for any reason, it is advisable to stop this class of drugs until complete recovery. People with type 2 diabetes who have had DKA once, should not restart these drugs and their diagnosis as well as capacity to secrete endogenous insulin should be reviewed.”

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Picture courtesy of HH E