Assessment of Insulin Infusion Requirements in COVID-19-Infected Patients With Diabetic Ketoacidosis.
Assessment of Insulin Infusion Requirements in COVID-19-Infected Patients With Diabetic Ketoacidosis.
复制标题
DOI：
10.1016/j.eprac.2022.05.006
复制
发表时间：
2022-08
影响因子：
4.2
通讯作者：
Schulman-Rosenbaum, Rifka
中科院分区：
文献类型：
--
作者：
Farzadfar, Daniela;Gordon, Caitlyn A.;Falsetta, Keith P.;Calder, Tori;Tsegaye, Adey;Kohn, Nina;Schulman-Rosenbaum, Rifka
关键词：
2019 年冠状病毒病 (COVID-19) 被认为会导致糖尿病酮症酸中毒 (DKA) 以及糖尿病患者的更差预后。这项研究比较了重症监护病房中感染 COVID-19 的 2 型糖尿病患者与未感染 COVID-19 的患者实现 DKA 缓解所需的累积胰岛素剂量。这项回顾性队列研究评估了 100 名患者（队列 1 中 50 名患有 COVID-19 的患者，队列 2 中 50 名未患 COVID-19 的患者），他们在三级护理教学医院接受胰岛素输注治疗 DKA。主要结果是比较每个队列中实现 DKA 解决所需的累积胰岛素剂量。次要结局包括 DKA 缓解的时间、平均胰岛素输注速率以及实现 DKA 缓解所需的基于体重的平均累积胰岛素输注剂量。所有终点均针对混杂因素进行了调整。第 1 组的平均累积胰岛素剂量为 190.3 单位，而第 2 组的平均累积胰岛素剂量为 116.4 单位 (P = .0038)。接受类固醇治疗的患者在队列 1 中平均 DKA 缓解时间为 35.9 小时，而在队列 2 中为 15.6 小时 (P = .0014)。在队列 1 和队列 2 中，平均胰岛素输注速率分别为 7.1 单位/小时和 5.3 单位/小时 (P = .0025)，而基于体重的平均累积胰岛素输注剂量分别为 2.1 单位/kg 和 1.5 单位/kg (P = .0437)。与未感染 COVID-19 的 2 型糖尿病患者相比，感染 COVID-19 的患者需要显着更大的累积胰岛素剂量、更长的 DKA 缓解时间、更高的胰岛素输注速率和更高的基于体重的胰岛素输注剂量才能实现 DKA 缓解。
Coronavirus disease 2019 (COVID-19) is thought to contribute to diabetic ketoacidosis (DKA) and worse outcomes in patients with diabetes. This study compared the cumulative insulin dose required to achieve DKA resolution in the intensive care unit among patients with type 2 diabetes and COVID-19 infection versus without COVID-19 infection. This retrospective cohort study evaluated 100 patients—50 patients with COVID-19 in cohort 1 and 50 patients without COVID-19 in cohort 2—treated with insulin infusions for DKA at a tertiary care teaching hospital. The primary outcome was to compare the cumulative insulin dose required to achieve DKA resolution in each cohort. The secondary outcomes included time to DKA resolution, mean insulin infusion rate, and mean weight-based cumulative insulin infusion dose required to achieve DKA resolution. All endpoints were adjusted for confounders. The mean cumulative insulin dose was 190.3 units in cohort 1 versus 116.4 units in cohort 2 (P = .0038). Patients receiving steroids had a mean time to DKA resolution of 35.9 hours in cohort 1 versus 15.6 hours in cohort 2 (P = .0014). In cohort 1 versus cohort 2, the mean insulin infusion rate was 7.1 units/hour versus 5.3 units/hour (P = .0025), whereas the mean weight-based cumulative insulin infusion dose was 2.1 units/kg versus 1.5 units/kg (P = .0437), respectively. COVID-19-infected patients required a significantly larger cumulative insulin dose, longer time to DKA resolution, higher insulin infusion rate, and higher weight-based insulin infusion dose to achieve DKA resolution versus non–COVID-19-infected patients with type 2 diabetes.
登录
查看更多内容
影响因子：
8.8
作者：
Roncon, Loris;Zuin, Marco;Zuliani, Giovanni
通讯作者：
Zuliani, Giovanni
影响因子：
13.8
作者：
Pasquel FJ;Messler J;Booth R;Kubacka B;Mumpower A;Umpierrez G;Aloi J
通讯作者：
Aloi J
成年糖尿病患者的高血糖危象。
影响因子：
16.2
作者：
Kitabchi AE;Umpierrez GE;Miles JM;Fisher JN
通讯作者：
Fisher JN
影响因子：
44.5
作者：
Apicella, Matteo;Campopiano, Maria Cristina;Prato, Stefano Del
通讯作者：
Prato, Stefano Del
影响因子：
158.5
作者：
Horby, Peter;Lim, Wei Shen;Landray, Martin J.
通讯作者：
Landray, Martin J.