Association of Blood Glucose Control and Outcomes in Patients With COVID-19 and Pre-existing Type 2 Diabetes

Cell Metab. 2020 Jun 2;31(6):1068-1077.e3. doi: 10.1016/j.cmet.2020.04.021. Epub 2020 May 1.

Abstract

Type 2 diabetes (T2D) is a major comorbidity of COVID-19. However, the impact of blood glucose (BG) control on the degree of required medical interventions and on mortality in patients with COVID-19 and T2D remains uncertain. Thus, we performed a retrospective, multi-centered study of 7,337 cases of COVID-19 in Hubei Province, China, among which 952 had pre-existing T2D. We found that subjects with T2D required more medical interventions and had a significantly higher mortality (7.8% versus 2.7%; adjusted hazard ratio [HR], 1.49) and multiple organ injury than the non-diabetic individuals. Further, we found that well-controlled BG (glycemic variability within 3.9 to 10.0 mmol/L) was associated with markedly lower mortality compared to individuals with poorly controlled BG (upper limit of glycemic variability exceeding 10.0 mmol/L) (adjusted HR, 0.14) during hospitalization. These findings provide clinical evidence correlating improved glycemic control with better outcomes in patients with COVID-19 and pre-existing T2D.

Keywords: COVID-19; SARS-CoV-2; blood glucose control; diabetes mellitus; mortality.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Betacoronavirus / pathogenicity
  • Blood Glucose / analysis*
  • Coronavirus Infections / complications
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / pathology
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / complications
  • Disease Susceptibility / pathology
  • Female
  • Glycemic Index / physiology*
  • Hospitalization / statistics & numerical data
  • Humans
  • Hyperglycemia / blood*
  • Hyperglycemia / complications
  • Hypoglycemic Agents / therapeutic use
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Multiple Organ Failure / complications
  • Multiple Organ Failure / mortality
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / pathology
  • Retrospective Studies

Substances

  • Blood Glucose
  • Hypoglycemic Agents

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2