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Could Exogenous Insulin Ameliorate the Metabolic Dysfunction Induced by Glucocorticoids and COVID-19?
- Source :
-
Frontiers in endocrinology [Front Endocrinol (Lausanne)] 2021 Jun 18; Vol. 12, pp. 649405. Date of Electronic Publication: 2021 Jun 18 (Print Publication: 2021). - Publication Year :
- 2021
-
Abstract
- The finding that high-dose dexamethasone improves survival in those requiring critical care due to COVID-19 will mean much greater usage of glucocorticoids in the subsequent waves of coronavirus infection. Furthermore, the consistent finding of adverse outcomes from COVID-19 in individuals with obesity, hypertension and diabetes has focussed attention on the metabolic dysfunction that may arise with critical illness. The SARS coronavirus itself may promote relative insulin deficiency, ketogenesis and hyperglycaemia in susceptible individuals. In conjunction with prolonged critical care, these components will promote a catabolic state. Insulin infusion is the mainstay of therapy for treatment of hyperglycaemia in acute illness but what is the effect of insulin on the admixture of glucocorticoids and COVID-19? This article reviews the evidence for the effect of insulin on clinical outcomes and intermediary metabolism in critical illness.<br />Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.<br /> (Copyright © 2021 Whyte, Vas and Umpleby.)
- Subjects :
- COVID-19 complications
Critical Care methods
Critical Illness therapy
Dexamethasone adverse effects
Dexamethasone therapeutic use
Diabetes Complications diagnosis
Diabetes Complications drug therapy
Diabetes Complications mortality
Diabetes Mellitus drug therapy
Diabetes Mellitus mortality
Diabetes Mellitus virology
Glucocorticoids therapeutic use
Humans
Hyperglycemia complications
Hyperglycemia drug therapy
Hyperglycemia mortality
Metabolic Diseases etiology
Obesity complications
Obesity drug therapy
Obesity mortality
SARS-CoV-2 physiology
Treatment Outcome
Glucocorticoids adverse effects
Insulin therapeutic use
Metabolic Diseases chemically induced
Metabolic Diseases prevention & control
COVID-19 Drug Treatment
Subjects
Details
- Language :
- English
- ISSN :
- 1664-2392
- Volume :
- 12
- Database :
- MEDLINE
- Journal :
- Frontiers in endocrinology
- Publication Type :
- Academic Journal
- Accession number :
- 34220705
- Full Text :
- https://doi.org/10.3389/fendo.2021.649405