Abstract
Diabetes has emerged as an important risk factor for severe illness and death from COVID-19. There is a paucity of information on glycemic control among hospitalized COVID-19 patients with diabetes and acute hyperglycemia. This retrospective observational study of laboratory-confirmed COVID-19 adults evaluated glycemic and clinical outcomes in patients with and without diabetes and/or acutely uncontrolled hyperglycemia hospitalized March 1 to April 6, 2020. Diabetes was defined as A1C ≥6.5%. Uncontrolled hyperglycemia was defined as ≥2 blood glucoses (BGs) > 180 mg/dL within any 24-hour period. Data were abstracted from Glytec's data warehouse. Among 1122 patients in 88 U.S. hospitals, 451 patients with diabetes and/or uncontrolled hyperglycemia spent 37.8% of patient days having a mean BG > 180 mg/dL. Among 570 patients who died or were discharged, the mortality rate was 28.8% in 184 diabetes and/or uncontrolled hyperglycemia patients, compared with 6.2% of 386 patients without diabetes or hyperglycemia (P < .001). Among the 184 patients with diabetes and/or hyperglycemia who died or were discharged, 40 of 96 uncontrolled hyperglycemia patients (41.7%) died compared with 13 of 88 patients with diabetes (14.8%, P < .001). Among 493 discharged survivors, median length of stay (LOS) was longer in 184 patients with diabetes and/or uncontrolled hyperglycemia compared with 386 patients without diabetes or hyperglycemia (5.7 vs 4.3 days, P < .001). Among hospitalized patients with COVID-19, diabetes and/or uncontrolled hyperglycemia occurred frequently. These COVID-19 patients with diabetes and/or uncontrolled hyperglycemia had a longer LOS and markedly higher mortality than patients without diabetes or uncontrolled hyperglycemia. Patients with uncontrolled hyperglycemia had a particularly high mortality rate. We recommend health systems which ensure that inpatient hyperglycemia is safely and effectively treated.
Highlights
IntroductionThere is a paucity of information on glycemic control among hospitalized COVID-19 patients with diabetes and acute hyperglycemia
Diabetes has emerged as an important risk factor for severe illness and death from COVID-19.1-4 In a small retrospective study of 191 adult patients admitted to 2 hospitals in Wuhan, China, diabetes was present in 19% of patients, and nonsurvivors were significantly more likely to have diabetes than survivors (31% vs 14%, P = .0051).[1]
Despite a preponderance of evidence that diabetes is associated with poor COVID-19 outcomes, there is a paucity of information on inpatient glycemic control among patients with diabetes and acute hyperglycemia hospitalized with COVID-19
Summary
There is a paucity of information on glycemic control among hospitalized COVID-19 patients with diabetes and acute hyperglycemia. Diabetes has emerged as an important risk factor for severe illness and death from COVID-19.1-4 In a small retrospective study of 191 adult patients admitted to 2 hospitals in Wuhan, China, diabetes was present in 19% of patients, and nonsurvivors were significantly more likely to have diabetes than survivors (31% vs 14%, P = .0051).[1] In a larger multicenter study assessing risk factors for complications of COVID-19 in 1099 patients hospitalized in China with COVID-19 illness, diabetes was present in 26.9% of patients achieving the primary endpoint of intensive care unit (ICU) admission, mechanical ventilation, or death, compared with 6.1% if none of these complications occurred.[2]. Despite a preponderance of evidence that diabetes is associated with poor COVID-19 outcomes, there is a paucity of information on inpatient glycemic control among patients with diabetes and acute hyperglycemia hospitalized with COVID-19.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
