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

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...

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Published inCell metabolism Vol. 31; no. 6; pp. 1068 - 1077.e3
Main Authors Zhu, Lihua, She, Zhi-Gang, Cheng, Xu, Qin, Juan-Juan, Zhang, Xiao-Jing, Cai, Jingjing, Lei, Fang, Wang, Haitao, Xie, Jing, Wang, Wenxin, Li, Haomiao, Zhang, Peng, Song, Xiaohui, Chen, Xi, Xiang, Mei, Zhang, Chaozheng, Bai, Liangjie, Xiang, Da, Chen, Ming-Ming, Liu, Yanqiong, Yan, Youqin, Liu, Mingyu, Mao, Weiming, Zou, Jinjing, Liu, Liming, Chen, Guohua, Luo, Pengcheng, Xiao, Bing, Zhang, Changjiang, Zhang, Zixiong, Lu, Zhigang, Wang, Junhai, Lu, Haofeng, Xia, Xigang, Wang, Daihong, Liao, Xiaofeng, Peng, Gang, Ye, Ping, Yang, Jun, Yuan, Yufeng, Huang, Xiaodong, Guo, Jiao, Zhang, Bing-Hong, Li, Hongliang
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 02.06.2020
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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. [Display omitted] •A cohort of 7,337 COVID-19 patients with or without diabetes was retrospectively studied•Diabetes status increased the need for medical interventions during COVID-19•Diabetes status increased the mortality risk of patients with COVID-19•Well-controlled blood glucose correlated with improved outcomes in infected patients Type 2 diabetes (T2D) correlates with a worse outcome for COVID-19. Here, Zhu et al. show that among ∼7,300 cases of COVID-19, T2D is associated with a higher death rate, but diabetics with better controlled blood glucose die at a lower rate than diabetics with poorly controlled blood glucose.
AbstractList 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.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.
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. [Display omitted] •A cohort of 7,337 COVID-19 patients with or without diabetes was retrospectively studied•Diabetes status increased the need for medical interventions during COVID-19•Diabetes status increased the mortality risk of patients with COVID-19•Well-controlled blood glucose correlated with improved outcomes in infected patients Type 2 diabetes (T2D) correlates with a worse outcome for COVID-19. Here, Zhu et al. show that among ∼7,300 cases of COVID-19, T2D is associated with a higher death rate, but diabetics with better controlled blood glucose die at a lower rate than diabetics with poorly controlled blood glucose.
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. Type 2 diabetes (T2D) correlates with a worse outcome for COVID-19. Here, Zhu et al. show that among ∼7,300 cases of COVID-19, T2D is associated with a higher death rate, but diabetics with better controlled blood glucose die at a lower rate than diabetics with poorly controlled blood glucose.
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.
Author Lu, Haofeng
Xia, Xigang
Chen, Xi
Zhang, Peng
Wang, Daihong
Cai, Jingjing
Song, Xiaohui
Chen, Guohua
Li, Haomiao
Lu, Zhigang
Zhang, Zixiong
Guo, Jiao
Liao, Xiaofeng
Li, Hongliang
Yan, Youqin
Liu, Mingyu
Wang, Junhai
She, Zhi-Gang
Chen, Ming-Ming
Huang, Xiaodong
Zou, Jinjing
Peng, Gang
Wang, Wenxin
Yang, Jun
Cheng, Xu
Mao, Weiming
Zhu, Lihua
Xiang, Da
Zhang, Changjiang
Zhang, Bing-Hong
Ye, Ping
Liu, Yanqiong
Liu, Liming
Yuan, Yufeng
Xie, Jing
Zhang, Chaozheng
Lei, Fang
Wang, Haitao
Bai, Liangjie
Xiang, Mei
Luo, Pengcheng
Zhang, Xiao-Jing
Qin, Juan-Juan
Xiao, Bing
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/32369736$$D View this record in MEDLINE/PubMed
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Keywords COVID-19
mortality
SARS-CoV-2
diabetes mellitus
blood glucose control
Language English
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Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
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Snippet 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...
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SubjectTerms Aged
Betacoronavirus - pathogenicity
Blood Glucose - analysis
blood glucose control
Clinical and Translational Report
Coronavirus Infections - complications
Coronavirus Infections - mortality
Coronavirus Infections - pathology
COVID-19
diabetes mellitus
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
mortality
Multiple Organ Failure - complications
Multiple Organ Failure - mortality
Pandemics
Pneumonia, Viral - complications
Pneumonia, Viral - mortality
Pneumonia, Viral - pathology
Retrospective Studies
SARS-CoV-2
Title Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes
URI https://dx.doi.org/10.1016/j.cmet.2020.04.021
https://www.ncbi.nlm.nih.gov/pubmed/32369736
https://www.proquest.com/docview/2399253357
https://pubmed.ncbi.nlm.nih.gov/PMC7252168
Volume 31
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