Use of a simpliﬁed local guideline improves “front door” management of diabetes and hyperglycaemia in people admitted to hospital with COVID-19

Background COVID-19, caused by the severe acute respiratory syndromecoronavirus-2 (SARS-CoV-2), was declared a pandemic on 11th March 2020. COVID-19 increases risk of hyperglycaemia regardless of prior diabetes diagnosis. Following results of the RECOVERY trial showing survival benefit in people with COVID-19 who required oxygen, dexamethasone has been used to improve outcomes.1 Dexamethasone (a glucocorticoid) may exacerbate hyperglycaemia in people with diabetes and can precipitate glucocorticoid-induced diabetes in others. In the context of COVID-19 infection, stress-related hyperglycaemia increases risk of mortality during hospitalization.2 In order to improve recognition and management of COVID-19-related hyperglycaemia, the National Diabetes Inpatient COVID response team published relevant guidance.3