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Source: BMČ - články
Issues for the management of people with diabetes and COVID-19 in ICU / A. Ceriello, E. Standl, D. Catrinoiu, B. Itzhak, NM. Lalic, D. Rahelic, O. Schnell, J. Škrha, P. Valensi, “Diabetes and Cardiovascular Disease (D&CVD)” Study Group of the European Association for the Study of Diabetes (EASD),
Ceriello, Antonio
IRCCS MultiMedica, Via Gaudenzio Fantoli, 16/15, 20138, Milan, Italy.

Standl, Eberhard
Forschergruppe Diabetes e.V. at Munich Helmholtz Centre, Munich, Germany.

Catrinoiu, Doina
Clinical Center of Diabetes, Nutrition and Metabolic Diseases, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania.

Itzhak, Baruch
Clalit Health Services and Technion Faculty of Medicine, Haifa, Israel.

Lalic, Nebojsa M
Clinic for Endocrinology, Diabetes and Metabolic Diseases, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Rahelić, Dario
Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia. University of Zagreb School of Medicine, Zagreb, Croatia. University of Osijek School of Medicine, Osijek, Croatia.

Schnell, Oliver
Forschergruppe Diabetes e.V. at Munich Helmholtz Centre, Munich, Germany.

Škrha, Jan
Department of Internal Medicine 3, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.

Valensi, Paul
Unit of Endocrinology, Diabetology, Nutrition, Jean Verdier Hospital, APHP, Paris Nord University, Sorbonne Paris Cité, CINFO, CRNH-IdF, Bondy, France.

“Diabetes and Cardiovascular Disease (D&CVD)” Study Group of the European Association for the Study of Diabetes (EASD)
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Cardiovascular diabetology. 2020, roč. 19, č. 1, s. 114. ISSN: 1475-2840 (elektronická verze).
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MESH descriptor
Betacoronavirus (patogenita)
antihypertenziva (terapeutické užití)
krevní glukóza (účinky léků, metabolismus)
diabetes mellitus (krev, diagnóza, farmakoterapie, mortalita)
hypertenze (farmakoterapie, mortalita)
hypoglykemika (škodlivé účinky, terapeutické užití)
jednotky intenzivní péče
virová pneumonie (diagnóza, mortalita, terapie, virologie)
rizikové faktory
biologické markery (krev)
výsledek terapie
koronavirové infekce (diagnóza, mortalita, terapie, virologie)
hodnocení rizik
statiny (terapeutické užití)
dyslipidemie (farmakoterapie, mortalita)
interakce hostitele a patogenu
English Abstract
In the pandemic "Corona Virus Disease 2019" (COVID-19) people with diabetes have a high risk to require ICU admission. The management of diabetes in Intensive Care Unit is always challenging, however, when diabetes is present in COVID-19 the situation seems even more complicated. An optimal glycemic control, avoiding acute hyperglycemia, hypoglycemia and glycemic variability may significantly improve the outcome. In this case, intravenous insulin infusion with continuous glucose monitoring should be the choice. No evidence suggests stopping angiotensin-converting-enzyme inhibitors, angiotensin-renin-blockers or statins, even it has been suggested that they may increase the expression of Angiotensin-Converting-Enzyme-2 (ACE2) receptor, which is used by "Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to penetrate into the cells. A real issue is the usefulness of several biomarkers, which have been suggested to be measured during the COVID-19. N-Terminal-pro-Brain Natriuretic-Peptide, D-dimer and hs-Troponin are often increased in diabetes. Their meaning in the case of diabetes and COVID-19 should be therefore very carefully evaluated. Even though we understand that in such a critical situation some of these requests are not so easy to implement, we believe that the best possible action to prevent a worse outcome is essential in any medical act.
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