Continuous Blood Glucose Monitoring to Determine the Glycemic Variability in Patients Having SARS CoV-2 Infection with ARDS and Its Bearing on the Severity of the Disease

Abstract

Aims and Objectives: A study to determine the effect of glycemic variability measured by continuous blood glucose monitoring as assessed by standard deviation of each SARS CoV -2 patient's mean glucose level and to correlate with the severity of the disease. Study Design: Cross-sectional observational study of 13 patients with SARS CoV-2 infection with Acute Respiratory Distress Syndrome (ARDS) with and without diabetes. Place and Duration of Study: Department of Medicine, Dhiraj Hospital, Smt. Bhikhiben Kanjibhai Shah Medical College and Research Institute; between June 2020 to July 2020. Results: 13 patients of SARS CoV-2 with ARDS were enrolled in the study. The median age of the enrolled patients was 55±12 years. Out of the 13 patients, 5 patients belonged to mild and severe category of ARDS each respectively and 3 patients belonged to the moderate category of ARDS. There was a gradual rise in inflammatory markers such as serum LDH, Ferritin, CRP from mild to severe ARDS and D-dimer level was more than double in severe category as compared to the mild ARDS. Normal glycemic variability in adults is 0-3 SD, and we found that there was a significant co-relation of glycemic variability with severity of the disease evidenced by the mean standard deviation of severe ARDS patients as 27.44 SD; whereas 19.26 SD and 9.7 SD for moderate and mild ARDS patients respectively. Hypoglycemia was documented in 10 patients. The maximum stay in the hospital was that of the patients with high glycemic variability that is 22 ± 2 days Conclusion: This preliminary study relates glycemic variability with severity of ARDS in patients of severe SARS CoV-2. Frequent episode of hypoglycemia is not uncommon and should be monitored.