Table 1

The pros and cons of several insulin regimens used in the ICU for patients with diabetes and COVID-19 on continuous tube feeding

Insulin infusion, i.v.Basal insulin q12h + Regular insulin q6h for correctionNPH insulin q8h + Regular insulin q8h for correctionRegular insulin q6h
Contact frequency/day24434
Glycemic control++++ (best)++++++
Glycemic variability+ (lowest)+++++++++
Risk of hypoglycemia upon TF interruption+++++++++
Mitigation protocolRelax the target blood glucose and test q2–4hReduce doses of basal insulin and add fixed doses of Regular insulin q6h plus correction by Regular insulin q6hNo mitigation is requiredNo mitigation is required
Infuse D10W at same rate if TF is interrupted for >2 h
Infuse D10W at same rate if TF is interrupted for >2 h
  • D10W, dextrose 10% in water; TF, continuous tube feeding.