COVID-19 patient put on steroids. How to manage sugars on OPD basis?

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ADDITION OF STEROIDS .. WILL LEADS TO .. INCREASE IN BSL .. ACCORDINGLY YOU HAVE TO ALTER YOUR LINE OF TREATMENT..

Tnx Dr Uday kumar Ms Natesun
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Management of sugars in Covid 19 Always use insulin for management of blood sugar Many lives are saved because of use of insulin in Covid 19 Glargine insulin would be a preferred choice as it has convenience of once a day dose and it controls fasting as well as part lunch blood sugar Short acting insulin can be added if post meal blood sugar is high. Please read my article on importance of insulin in management Covid 19 https://jmscr.igmpublication.org/home/index.php/archive/178-volume-08-issue-07-july-2020/9517-use-of-insulin-in-treatment-of-covid-19-a-proposal-to-explore-feasibility

When I am adding steroids like Wysolone 20 mg BD or methylprednisolone 16mg BD, then I add Repaglinide 2mg before every meals and morning and night dose of other drugs too, but still sugars uncontrolled. What are you all following? Switching to insulins

Slight rise in blood glucose possibly After assessment and evaluation you can change line of treatment and change in life style. Tapering of dose of steroid advisable.

Thanks Dr Pushkar Bhomia
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Consult Endocrinologist/physician at earliest to initiate or optimize OAD B. If there is an anticipated delay in consulting endocrinologist/physician, initiate on Tab Metformin (either immediate or sustained release) 500 mg BD and a Gliptin (Tab Vildagliptin 50 mg BD or Tab Sitagliptin 100 mg OD or Tab Linagliptin 5 mg OD or Tab Teneligliptin 20 mg OD), provided patient meets all the following criteria: i. Pre-meal blood glucose is between 150 and 180 mg/dl and/or post-meal blood glucose is between 200 and 250 mg/d

Monitoring of blood sugar by glucometer at home & adjust dose of drug you are using

Slight rise of sugar possible Triturate dose according to Fasting pp sugar Sometimes steriod helps in uncontrollable dm

As an antiinflammatories

NICELY DISCUSSED. IN DETAILS THANKS. DR

PREFERABLE DRUG TOCILOZUMAB OR ITOLIZUMAB