Management of steroid induced hyperglycemia in COVID 19 patients .during and after discharge?

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Steroids induce insulin resistance by directly interfering with signaling cascades, mainly the GLUT4 transporter, within muscle cells, with the subsequent 30%-50% reduction in insulin-stimulated glucose uptake and a 70% reduction in insulin-stimulated glycogen synthesis. On the other hand, steroids are responsible for the catabolism of proteins with the subsequent increase in serum amino acids, which also interfere with insulin signaling in the muscle cell. Finally, they increase lipolysis, resulting in an increase in serum free fatty acids and triglycerides. These promote the accumulation of intramyocellular lipids (acetyl coenzyme A, diacylglycerol and ceramide), reducing the entry and storage of intramuscular glucose. the best treatment the first consideration to make is whether to use oral hypoglycemic drugs or insulin**

thanx Dr. Abira Ji
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Please read my article on benefit of insulin for treatment of 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 Certainly insulin is best option for treatment of hyperglycaemia!

Thank you doctor
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Please use insulin Glargine insulin is preferred option

Thank you doctor
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Inj Glargine for basal bolus Inj Actrapid before each meal .

I agree
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dexamethasone therapy

DPP4 INHIBITORS SLGT2 INHIBITORS INSULINS

Insulin is the best option. U can slowly shift to OAD after discharge

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