ECE2021 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (82 abstracts)
A death case of type 1 diabetes mellitus due to COVID-19
Kader Ugur 1 , İlknur Karatas 2 , Ramazan Fazıl Akkoç 3 & Süleyman Aydın 4
1Firat University, Elazig, Turkey, Department of Internal Medicine (Endocrinology and Metabolism Diseases), Faculty of Medicine, Elazig, Turkey; 2Firat University, Elazig, Turkey., Department of Internal Medicine, Faculty of Medicine, Elazig, Turkey; 3Firat University, Elazig, Turkey., Department of Anatomy, Faculty of Medicine, Elazig, Turkey; 4Firat University, Elazig, Turkey., Department of Medical Biochemistry and Clinical Biochemistry (Firat Hormones Research Group), Faculty of Medicine, Elazıg, Turkey
Introduction
The prevalence and mortality of the new type of coronavirus (SARS Cov-2) are high in patients with metabolic disease, especially in diabetes circumstances. Therefore, this study aims to present the changes in the clinical and biochemical parameters of a patient with Type 1 diabetes who died due to Covid-19.
Case
| eGFR (ml/min/ 1.73 m2) | 15 |
| Glucose (mg/dl) | 1050 |
| HbA1c (%) | >15 |
| WBC (10e3/μl) | 6.56 |
| Lymphocyte (10e3/μl) | 0.85 |
| Hgb (g/dl) | 7.5 |
| AST (U/L) | 24 |
| ALT (U/L) | 8 |
| Urea (mg/dl) | 157 |
| Creatinine (mg/dl) | 3.89 |
| Sedimentation (mm/h) | 102 |
| CRP (mg/l) | 35.6 |
| Ferritin (ng/ml) | 1030 |
| D-Dimer (mg/l) | 0.4 |
| Fibrinogen (mg/dl) | 754 |
| PO2/FiO2 | 118 |
| Procalcitonin (mg/l) | 0.38 |
The case is a 24-year-old female patient who has been followed up in our hospital with the diagnosis of Type 1 diabetes, Celiac disease, and osteoporosis due to secondary hypogonadism for years. Again, this patient had been receiving treatment for chronic renal failure and hypertension due to diabetic nephropathy for 2 years. She was using inhaler ß2 agonists and corticosteroids for 1 year because of her asthma bronchiale. In addition, the case was underdeveloped compared to her peers and was 140 cm tall and 40 kg in weight. Initially, the patient was admitted to our hospital with a blood glucose level of 1050 mg/dl and a diagnosis of diabetic ketoacidosis (Table 1). In addition, since the patient was accompanied by dyspnea and nasal discharge, it was consulted with the clinic of infectious diseases. Her blood and urine cultures were taken and sent for Covid-19 PCR. The ground-glass images in the Thorax CT result were compatible with pulmonary edema and pulmonary embolism. Appropriate fluid replacement and intravenous insulin infusion treatment were initiated until the infection results were obtained. Despite all the treatments, target values determined for diabetes could not be achieved for this patient. We were able to reduce blood glucose by a maximum of 250 mg/dl. Additionally, the patient’s electrolyte and blood gas were monitored. In its follow-up, treatment-resistant fever 39.5 °C was measured. Despite all efforts, the O2 saturation of the patient fell below 70 mmHg. As soon as Covid-19 was diagnosed, she was taken to the Covid-19 intensive care unit, and her glucose follow-up was followed up continuously and she was intubated. However, our patient died 1 day later.
Conclusion
As a result, it was observed that blood glucose regulation is more difficult in patients with new types of coronavirus infection.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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