在COVID-19的严重病例中,胰岛素需求的增加高于中度病例
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
概括
患有严重COVID-19的患者需要更高剂量的胰岛素. 对于COVID-19患者的最大胰岛素需求与血红蛋白A1c和呼吸器等呼吸支持有关.
科学领域:
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 冠状病毒疾病2019 (COVID-19) 可能导致显著的代谢障碍.
- 住院COVID-19患者的血糖控制通常需要胰岛素治疗.
- COVID-19严重程度和胰岛素需求之间的关系仍未得到充分研究.
研究的目的:
- 为了确定COVID-19患者血糖控制所需的最大每日总胰岛素剂量.
- 根据COVID-19的严重程度,确定达到最大胰岛素剂量的时间过程.
- 调查影响在住院期间最大胰岛素剂量要求的因素.
主要方法:
- 对20至90岁需要胰岛素的COVID-19患者进行了回顾性队列研究.
- 从2020年3月到2021年5月在单一大学医院收集的数据.
- 线性回归分析用于确定最大胰岛素剂量的决定因素.
主要成果:
- 根据COVID-19的严重程度,最大胰岛素剂量有显著的变化:每天31.8个单位 (没有呼吸机),每天76.8个单位 (呼吸机) 和每天230.7个单位 (呼吸机+ECMO).
- 通常在诊断后2周左右达到最大胰岛素剂量.
- 血红蛋白A1c,呼吸机使用和体外膜氧化 (ECMO) 是较高最大胰岛素剂量的独立预测因素.
结论:
- 与中度病例相比,严重的COVID-19需要更高的最大胰岛素剂量.
- 在严重的COVID-19中,血糖管理需要仔细监测和调整胰岛素.
- 摄入血红蛋白A1c和需要先进的呼吸辅助是确定胰岛素需求的关键因素.
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