Kosinski Christophe, Zanchi Anne, Wojtusciszyn Anne
Service d'Endocrinologie, Diabétologie et Métabolisme, CHUV, 1011 Lausanne.
Laboratoire de Thérapie Cellulaire du Diabète, IRMB, CHU Montpellier, 34295 Montpellier, France.
Rev Med Suisse. 2020 May 6;16(692):939-943.
Based on the epidemiological data currently available, diabetes does not seem to be a risk factor for infection with SARS-CoV-2 but may be associated with a more severe course. Diabetes is extremely common in older patients with co-morbidities who are at risk of unfavorable outcomes. As with any other infection, poorly controlled pre-existing diabetes can promote secondary infections and lead to acute complications related to hyperglycemia, worsened itself by the infection. It is important to advise patients to have enough diabetic equipment and supplies at home, to make regular blood glucose self-tests, and to contact a caregiver immediately in case of glycemic imbalance or signs of infection. Antidiabetic therapy may need adjustments following usual sick day rules. Insulin therapy should be considered to treat any persistent hyperglycemia in patients hospitalized for an acute infection.
根据目前可得的流行病学数据,糖尿病似乎不是感染新型冠状病毒的风险因素,但可能与病情更严重有关。糖尿病在患有合并症且有不良预后风险的老年患者中极为常见。与任何其他感染一样,原有控制不佳的糖尿病会促进继发感染,并导致与高血糖相关的急性并发症,而感染又会使糖尿病病情恶化。建议患者在家中备足糖尿病设备和用品,定期进行血糖自我检测,一旦出现血糖失衡或感染迹象,应立即联系护理人员,这很重要。抗糖尿病治疗可能需要按照常规的患病日规则进行调整。对于因急性感染住院的患者,应考虑采用胰岛素治疗持续性高血糖。