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The article discusses that high doses of glucocorticoids exacerbate hyperglycaemia in people with diabetes. It mentions that glucocorticoids are the commonest cause of people with diabetes developing potentially life-threating hyperglycaemic hyperosmolar state (HHS) in hospital. It also mentions that COVID-19 infection is associated with significant insulin resistance.

The National Diabetes Stakeholders Covid‐19 Response Group was formed in early April 2020 as a rapid action by the Joint British Diabetes Societies for Inpatient Care, Diabetes UK, the Association of British Clinical Diabetologists, and Diabetes Frail to address and support the special needs of residents with diabetes in UK care homes during Covid‐19. It was obvious that the care home sector was becoming a second wave of Covid‐19 infection and that those with diabetes residing in care homes were at increased risk not only of susceptibility to infection but also to poorer outcomes. Its key purposes included minimising the morbidity and mortality associated with Covid‐19 and assisting care staff to identify those residents with diabetes at highest risk of Covid‐19 infection. The guidance was particularly created for care home managers, other care home staff, and specialist and non‐specialist community nursing teams. The guidance covers the management of hyperglycaemia by discussion of various clinical scenarios that could arise, the management of hypoglycaemia, foot care and end of life care. In addition, it outlines the conditions where hospital admission is required. The guidance should be regarded as interim and will be updated as further medical and scientific evidence becomes available. Novelty statement: This rapid response guidance represents the first national stakeholder action to address the special needs and vulnerabilities of care home residents with diabetes during Covid‐19This guidance is designed to support clinical decision‐making in care homes and takes into account the availability of skilled personnel and level of care present, and the inevitable limitations on diabetes monitoringA set of different clinical scenarios are given covering the various likely situations care staff will face with residents with diabetes who develop Covid‐19 and what are the key actions to take to improve outcomesThe guidance provides an optimal level of diabetes care approach during the exceptional circumstances of this pandemic but the Response Group recognises that care home settings may not be able to fully meet this unprecedented challenge [ABSTRACT FROM AUTHOR]

The article discusses the guidance on the management of inpatient hyperglycaemia in the midst of the coronavirus disease 2019 (COVID-19) pandemic, published by the British National Diabetes Inpatient COVID-19 Response Group. Topics explored include the impact of the pandemic on the delivery of acute inpatient care to individuals with diabetes, the recommendations on the adjustment of long-acting insulin dosages, and brief details about the updates to the existing clinical guidance.