Dexamethasone guideline published by national COVID-19 group
Guidance aiming to ensure all inpatients on dexamethasone receive appropriate glucose surveillance and appropriate managements of hyperglycaemia has been released.
It is the latest instalment from the National Inpatient Diabetes COVID-19 Response Group, set up during the coronavirus crisis and chaired by Professor Gerry Rayman MBE.
According to studies, dexamethasone reduces mortality in people with COVID-19 who require ventilation or oxygen therapy, but the use of steroids can result in significant hyperglycaemia in people with diabetes and new onset diabetes in those previously undiagnosed.
In response, the group has put together: COncise adVice on Inpatient Diabetes (COVID:Diabetes): Dexamethasone Therapy in COVID-19 Patients: Implications and Guidance for the Management of Blood Glucose in People with and Without Diabetes.
This guidance is for use in all inpatients with COVID-19 who are treated with dexamethasone in a ward setting. It is not intended for Critical Care Units but may be adapted for this use.
It differs from the previous COncise adVice on Inpatient Diabetes (COVID:Diabetes): Guidance for managing inpatient hyperglycaemia as it targets the greater insulin resistance in dexamethasone-treated patients and should only be used in this context, the authors said.
The clinical guidance has been pulled together with insight from clinical leads across UK centres which have so far gathered the greatest experience of looking after people with diabetes and COVID-19.
The Response Group has also issued other documents to aid healthcare professionals during the pandemic.
- ‘COncise adVice on Inpatient Diabetes (COVID Diabetes) Safe and supported discharge to reduce readmissions and improve patient flow’
- COncise adVice on Inpatient Diabetes (COVID:Diabetes): Guidance for managing inpatient hyperglycaemia
- COncise adVice on Inpatient Diabetes (COVID:Diabetes): Guideline for managing DKA using subcutaneous insulin
- COncise adVice on Inpatient Diabetes (COVID:Diabetes) – Front Door Guidance, this guidance is for diabetes specialist teams, as well as all those involved in delivering care to people with diabetes at the front door.
- View a letter from the team highlighting the need to maintain patient safety whilst accelerating patient flow through the system, including preventing avoidable admissions and readmissions.
- Maintaining acute diabetes services in response to COVID-19
- Speciality template for acute diabetes services
Trend Diabetes, a working group of nurses with a wide range of different skills and backgrounds, also has a leaflet entitled Type 2 Diabetes and Steroid Treatment, that provides essential information on the best way to approach taking the medication and after care for people taking steroids.