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Updated: Dec 14, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
COVID-19 and diabetes: Insulin requirements parallel illness severity in critically unwell patients
Linda Wu1, Christian M Girgis1,2, Ngai Wah Cheung1,2
1Department of Diabetes & Endocrinology, Westmead Hospital, Sydney, NSW, Australia.
Objective:
In the light of increased adverse outcomes for people with diabetes affected by COVID-19, we have described the clinical course of a cohort of critically ill patients with COVID-19 and diabetes.
Methods:
We retrospectively analysed characteristics, glucometrics and inflammatory markers of patients with diabetes mellitus admitted to intensive care unit (ICU) with COVID-19.
Results:
Eight patients with diabetes were admitted to ICU with COVID-19. All had type 2 diabetes, with three being newly diagnosed that admission. Mean HbA1c was 9.2%. Glucometric analysis indicated that extremely high insulin doses were required during peak inflammatory response to maintain glycaemic control with a mean peak insulin requirement of 201 units per day (2.2 units/kg/day).
Conclusions:
Critically unwell patients with diabetes mellitus and COVID-19 had high insulin requirements and poorer time in target range at the time of peak inflammatory response, and this improved as their illness resolved.
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