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COVID-19 and emergencies in patients with diabetes: two case reports

Rajib Kumar Dey1, Abdullah Isneen Hilmy2, Hisham Ahmed Imad3,4

  • 1Department of Internal Medicine, Indira Gandhi Memorial Hospital, Male', Maldives. dr_rajibdey@yahoo.co.uk.

Journal of Medical Case Reports
|February 3, 2021
PubMed

Insights

COVID-19 patients with diabetes face higher risks of severe complications like diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). Prompt monitoring and aggressive management of these diabetic emergencies are crucial for better outcomes.

Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Nephrology

Background:

  • The Maldives reported its first COVID-19 case in March 2020, with over 9400 cases and 33 deaths.
  • COVID-19 patients with diabetes exhibit poorer prognoses and higher mortality rates.
  • Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are potentially lethal complications that can be precipitated by COVID-19 in poorly controlled diabetic patients.

Observation:

  • Two cases of diabetic emergencies in COVID-19 patients are presented.
  • Case 1: A 53-year-old male with moderate COVID-19 presented with DKA and acute kidney injury.
  • Case 2: A 72-year-old male with mild COVID-19 developed HHS and acute kidney injury.

Findings:

  • Both patients were managed conservatively in the ICU with intravenous fluids and insulin.
  • The study highlights a scarcity of reported cases of diabetic emergencies during the pandemic, despite frequent reports of uncontrolled diabetes.

Implications:

  • Clinicians must closely monitor diabetic patients with COVID-19 to prevent emergencies like DKA and HHS.
  • Aggressive management of these diabetic emergencies is essential for favorable patient outcomes.
  • This underscores the critical interplay between diabetes management and COVID-19 care.
Abstract

Keywords:
COVID-19DiabetesDiabetic emergenciesDiabetic ketoacidosisHyperosmolar hyperglycemic statePandemic

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