1Division of Diabetes and Endocrinology, Hyogo Prefectural Kakogawa Medical Center, Kakogawa, Japan
2Division of Nephrology, Hyogo Prefectural Kakogawa Medical Center, Kakogawa, JapanFulltext PDF
We report the case of a 77-year-old Japanese man with coronavirus disease 2019 (COVID-19) who developed diabetic ketoacidosis (DKA). He is administered oral agents for type 2 diabetes mellitus, which he was diagnosed with 35 years ago by a home doctor. Three years before his COVID-19 infection, his glycemic control deteriorated, and he started multiple daily insulin injections. He presented to our emergency outpatient department with fatigue and respiratory distress. The patient was diagnosed with COVID-19 concomitant with DKA. Dexamethasone is the recommended treatment for COVID-19 infection. The patient was treated with an intravenous fluid infusion and continuous insulin administration for DKA. The patient's clinical course was followed up with arterial blood gas and serum glucose monitoring using intermittently scanned continuous glucose monitoring (isCGM). We successfully treated DKA using isCGM and reduced the exposure of the medical staff to infected patients. Although DKA was in remission, the COVID-19 infection worsened, and the patient eventually died. The necessity for alternative methods for the management of patients with DKA and COVID-19 infection is paramount during the pandemic period.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2); COVID-19; Diabetic ketoacidosis; Dexamethasone; Continuous Glucose Monitoring
Yasunori Fujita, Yuya Onishi, Masahiko Furuya, Miki Watanabe, Nozomi Kido, Yuka Ohmachi, Yuko Inayama, Yuya Kashitani, Naho Goda, Keiko Ishii, Ikuhiro Ishida, Sachiko Nakamura, Keiji Iida. A Case of Diabetic Ketoacidosis Induced by Covid-19 Successfully Treated with Continuous Glucose Monitoring. Int Case Rep Jour. 2022;2(6):1-8.