PMID- 32668399
OWN - NLM
STAT- MEDLINE
DCOM- 20200928
LR  - 20221207
IS  - 1878-0334 (Electronic)
IS  - 1871-4021 (Print)
IS  - 1871-4021 (Linking)
VI  - 14
IP  - 5
DP  - 2020 Sep-Oct
TI  - Hypoglycemia at the time of Covid-19 pandemic.
PG  - 1143-1146
LID - S1871-4021(20)30249-6 [pii]
LID - 10.1016/j.dsx.2020.07.003 [doi]
AB  - BACKGROUND: Hypoglycemia is the limiting factor in the glycemic management of 
      diabetes, which need to be addressed critically to avoid complications. Lockdown 
      because of new coronavirus strain (COVID-19) pandemic has further complicated the 
      issue of hypoglycemia due to limitations in access to food, outpatient clinics, 
      pathological services and medicines. AIM: To assess the factors associated with 
      the risk of hypoglycemia during April-May 2020 lockdown in people with type 2 
      diabetes mellitus. METHODOLOGY: We analyzed the data retrospectively from 146 
      patients of type 2 diabetes mellitus (T2DM) reporting to the emergency department 
      (ED) during lockdown period with symptoms suggestive of hypoglycemia. RESULTS: 
      The majority of patients were male (90/146) with a mean age of 59.88 +/- 10.09 
      years and a mean random blood glucose level of 57.67 +/- 9.00 mg/dL. Two-third of 
      patients (70.83%) had level 1 hypoglycemia, while level 2 hypoglycemia was 
      reported in 29.16% of patients. A combination of Metformin and Sulfonylureas (SU) 
      was most commonly associated with the risk of hypoglycemia (65.75%) followed by 
      insulin (33.56%). Subjects who received insulin reported a lower blood glucose 
      value (50.75 +/- 8.20 mg/dL) as compared to those receiving a combination of 
      metformin and SU (60.95 +/- 7.10 mg/dl). 330.56% of patients who had received 
      prophylaxis hydroxychloroquine (HCQ) 400 mg twice a day along with the routine 
      anti-hyperglycemic agents without their dose adjustment reported hypoglycemia. 
      Patients with hypertension, micro-vascular, macro-vascular complications, and 
      coexistent with each other had a higher propensity to the risk of hypoglycemia 
      (46.58%, 33.56%, 23.29%, and 32.88%) respectively. CONCLUSION: The COVID-19 
      lockdown has shown to influence the risk of hypoglycemia in patients with T2DM, 
      especially those receiving SU, insulin, HCQ especially in patients with 
      associated co-morbidities. Patient education, support, and telemedicine plays a 
      pivotal role to prevent hypoglycemia.
CI  - Copyright (c) 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.
FAU - Shah, Kiran
AU  - Shah K
AD  - Diabetes & Thyroid Care Center, India. Electronic address: drkiranshh@gmail.com.
FAU - Tiwaskar, Mangesh
AU  - Tiwaskar M
AD  - Shilpa Medical Research Centre, India. Electronic address: tiwaskar@gmail.com.
FAU - Chawla, Purvi
AU  - Chawla P
AD  - Lina Diabetes Care and Mumbai Diabetes Research Centre, India. Electronic 
      address: purvi_chawla@yahoo.com.
FAU - Kale, Mayura
AU  - Kale M
AD  - Dr Kale's Diabetes and Psychiatry Clinic, India. Electronic address: 
      kalediabetesclinic@gmail.com.
FAU - Deshmane, Rajesh
AU  - Deshmane R
AD  - Shree Mahalaxmi Diabetic Care Centre, India. Electronic address: 
      smdcc_kolhapur@yahoo.com.
FAU - Sowani, Alpana
AU  - Sowani A
AD  - Diabetes Specialty Centre, India. Electronic address: alpanasowani@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20200710
PL  - Netherlands
TA  - Diabetes Metab Syndr
JT  - Diabetes & metabolic syndrome
JID - 101462250
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Betacoronavirus/*isolation & purification
MH  - Biomarkers/analysis
MH  - Blood Glucose/analysis
MH  - COVID-19
MH  - Coronavirus Infections/*complications/transmission/virology
MH  - Diabetes Mellitus, Type 2/*physiopathology
MH  - Female
MH  - Follow-Up Studies
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - Hypoglycemia/*epidemiology/virology
MH  - Incidence
MH  - India/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Pandemics
MH  - Pneumonia, Viral/*complications/transmission/virology
MH  - Prognosis
MH  - Retrospective Studies
MH  - SARS-CoV-2
PMC - PMC7347476
OTO - NOTNLM
OT  - Anti-diabetic agents
OT  - COVID-19
OT  - Comorbidities
OT  - Hypoglycemia
COIS- Declaration of competing interest None, Declared.
EDAT- 2020/07/16 06:00
MHDA- 2020/09/29 06:00
PMCR- 2020/07/10
CRDT- 2020/07/16 06:00
PHST- 2020/06/10 00:00 [received]
PHST- 2020/06/29 00:00 [revised]
PHST- 2020/07/02 00:00 [accepted]
PHST- 2020/07/16 06:00 [pubmed]
PHST- 2020/09/29 06:00 [medline]
PHST- 2020/07/16 06:00 [entrez]
PHST- 2020/07/10 00:00 [pmc-release]
AID - S1871-4021(20)30249-6 [pii]
AID - 10.1016/j.dsx.2020.07.003 [doi]
PST - ppublish
SO  - Diabetes Metab Syndr. 2020 Sep-Oct;14(5):1143-1146. doi: 
      10.1016/j.dsx.2020.07.003. Epub 2020 Jul 10.