Glycemic control is linked to reduced morbidity, mortality in COVID-19


  • Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Among COVID-19 patients with preexisting type 2 diabetes (T2D), blood glucose (BG) within 3.9-10.0 mmol/L is associated with improved outcomes.

Why this matters

  • T2D is a common COVID-19 comorbidity, but evidence linking it to outcomes is limited.

Study design

  • Retrospective, multicenter study of 7337 COVID-19 cases in Hubei Province, China.
  • Funding: National Key R&D Program of China; National Science Foundation of China.

Key results

  • During 28 days postadmission, with T2D (n=923) vs without (n=6385), increased risk for all-cause in-hospital mortality:
    • HR, 1.49 (P=.005).
    • HR was adjusted for age, sex, COVID-19 severity.
  • In T2D group, with well-controlled glycemia (n=282; BG upper limit ≤10 mmol/L; average HbA1c, 7.3%) vs poorer control (n=528; BG upper limit >10 mmol/L; HbA1c, 8.1%), decreased risk for in-hospital death:
    • HR, 0.13 (P<.001>
    • HR adjusted for age, sex, and COVID-19 severity, comorbidities. 
  • Adjusted risks (HRs) with good vs poor control were reduced for:
    • Acute respiratory distress syndrome: 0.41 (P<.001 and>
    • Acute heart injury: 0.21 (P=.003).
  • In 1:1 propensity match, all-cause adjusted mortality risk with well-controlled BG (n=250) vs poor control (n=250) was lower:
    • HR: 0.14 (P=.008).

Limitations

  • All inpatients, from 1 Chinese province.
  • No data on prehospital T2D status.
  • Small number of participants with good control.
  • Retrospective.