AREAS COVERED: We discussed various aspects of pharmacotherapeutic management in hospitalized patients with COVID-19: (i) susceptibility and severity of COVID-19 among individuals with diabetes, (ii) glycemic goals for hospitalized patients with COVID-19 and concurrent diabetes, (iii) pharmacological treatment considerations for hospitalized patients with COVID-19 and concurrent diabetes.
EXPERT OPINION: The glycemic goals in patients with COVID-19 and concurrent type 1 (T1DM) or type 2 diabetes (T2DM) are to avoid disruption of stable metabolic state, maintain optimal glycemic control, and prevent adverse glycemic events. Patients with T1DM require insulin therapy at all times to prevent ketosis. The management strategies for patients with T2DM include temporary discontinuation of certain oral antidiabetic agents and consideration for insulin therapy. Patients with T2DM who are relatively stable and able to eat regularly may continue with oral antidiabetic agents if glycemic control is satisfactory. Hyperglycemia may develop in patients with systemic corticosteroid treatment and should be managed upon accordingly.
RESEARCH DESIGN AND METHODS: A combined retrospective chart review and cross-sectional survey was conducted at the Psychiatry and Mental Health Clinic of Hospital Kuala Lumpur (HKL) over an 18-month period, examining 286 patients diagnosed with MDD or TRD. Data were analyzed from governmental and societal perspectives, including direct medical costs, indirect costs, and other resource utilization.
RESULTS: TRD patients exhibited significantly higher health-care utilization, including a fivefold increase in the likelihood of attending more than 10 consultations (p = 0.035) and greater use of second-generation antipsychotics (p