Managing hyperglycemia during the COVID-19 pandemic: Improving outcomes using new technologies in intensive care

Hyperglycemia is a significant risk for mortality in COVID-19 infections and is most dramatically noted in critically ill patients. Hyperglycemia and/or diabetes are noted in approximately 30%–40% of patients admitted with COVID-19 infections. Previous studies have shown a marked increase in mortality related to increased glucose concentrations and reduction with improved glucose control. In vivo and in vitro studies reveal the mechanisms by which hyperglycemia increases virulence and how glucose control and insulin reduce it. Optimal glucose control in intensive care is limited by manual sampling of glucose and intravenous insulin adjustment, as well as increased nursing workload and the need of protective equipment. Tools for safe and effective automation of glucose control in intensive care are discussed. A suitable closed loop device could save the lives of thousands of hospitalized hyperglycemic individuals infected with COVID-19 while protecting medical professionals from infection risk.