Abstract

Many patients with covid 19 infection have increased blood sugar at the time of admission. Some of them are not a known diabetic patients before. The covid infection and the use of steroids in treatment worsens the glygemic status of the patients. The hyperglycemia has a significant impact on the outcome . This study compares the management of hyperglycemia in covid 19 patients using subcutaneous insulin with the use of continuous insulin infusion.
Methods :
This is a single centered , prospective , case control study conducted in a tertiary care centre for a period of 6 months. Covid 19 patients with moderate and severe symptoms who are admitted with hyperglycemia are recruited for the study. They were randomised into Group A who were treated with continuous intravenous insulin infusion and Group B who were treated with subcutaneous insulin. The mortality , duration of hospital stay and the hypoglycemic events were studied as outcome.
Results :
During the study period 316 patients with admission blood sugar ≥ 200 mg/dl were recruited in the study. Of the 163 patients in group A who were treated with intravenous insulin infusion 12 patient died and of the 153 patients in group B who were treated with subcutaneous insulin 23 died. The mean duration of stay among the group A and and group B was 3.28 and 4.71 days respectively. The number of hypoglycemic events  in group A were 24 and in group B were 17 which was not statistically significant.
Conclusion :
The continuous intravenous insulin infusion strategy to treat hyperglycemia in covid 19 patients has a significant reduction in the mortality and duration of hospital stay without significant increase in hypoglycemic events