Related Experiment Video

Updated: Jun 7, 2025

Author Spotlight: Exploring the Impact of Reduced Resistance Exercise Volume on Metabolic Health
06:13

Author Spotlight: Exploring the Impact of Reduced Resistance Exercise Volume on Metabolic Health

Published on: December 1, 2023

1.0K

Increased Insulin Requirements in Severe Cases of Covid-19 are Higher Than in Moderate Cases

Takaaki Matsui1, Emi Ushigome1, Masahide Hamaguchi1

  • 1Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan.

Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy
|November 14, 2024
PubMed

Insights

Patients with severe COVID-19 require higher insulin doses. Maximum insulin needs for COVID-19 patients were linked to hemoglobin A1c and respiratory support like ventilators.

Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) can cause significant metabolic disturbances.
  • Glycemic control in hospitalized COVID-19 patients often requires insulin therapy.
  • The relationship between COVID-19 severity and insulin requirements remains understudied.

Purpose of the Study:

  • To determine the maximum total daily insulin dose needed for glycemic control in COVID-19 patients.
  • To identify the time course for reaching maximum insulin dosage based on COVID-19 severity.
  • To investigate factors influencing maximum insulin dose requirements during hospitalization.

Main Methods:

  • Retrospective cohort study of 20-90 year old COVID-19 patients requiring insulin.
  • Data collected from March 2020 to May 2021 at a single university hospital.
  • Linear regression analyses used to identify determinants of maximum insulin dose.

Main Results:

  • Maximum insulin doses varied significantly with COVID-19 severity: 31.8 U/day (no ventilator), 76.8 U/day (ventilator), and 230.7 U/day (ventilator + ECMO).
  • Maximum insulin dose was typically reached around 2 weeks post-diagnosis.
  • Hemoglobin A1c, ventilator use, and extracorporeal membrane oxygenation (ECMO) were independent predictors of higher maximum insulin doses.

Conclusions:

  • Severe COVID-19 necessitates substantially higher maximum insulin doses compared to moderate cases.
  • Glycemic management in severe COVID-19 requires careful monitoring and adjustment of insulin.
  • Admission hemoglobin A1c and need for advanced respiratory support are critical factors in determining insulin needs.
Abstract

Keywords:
COVID-related diabetesSARS-CoV-2glycemic controlinsulin resistanceretrospective cohort study

More Related Videos

Improving IV Insulin Administration in a Community Hospital12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

18.8K
A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-1906:46

A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19

Published on: July 5, 2022

2.7K

Related Concept Videos

Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
146
Diabetes: Symptoms, Diagnosis, and Complications01:15

Diabetes: Symptoms, Diagnosis, and Complications

For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
508
Overview of Carbohydrate Metabolism01:19

Overview of Carbohydrate Metabolism

Carbohydrate metabolism is a fundamental biochemical process that ensures a constant supply of energy to living cells. The most important carbohydrate is glucose, which can be broken down via glycolysis to enter into the Krebs cycle and eventually lead to the production of ATP through oxidative phosphorylation.
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
753
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
152
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.2K
Diabetes Mellitus: Overview and Type I Subtype01:22

Diabetes Mellitus: Overview and Type I Subtype

Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
2.4K