Study: Patients with COVID-19, Diabetes, Uncontrolled Hyperglycemia Have Significantly Higher Mortality

Although it is already well established that diabetes is a notable risk factor for the coronavirus disease 2019 (COVID-19), new research has found that hospitalized patients with COVID-19, diabetes, and/or uncontrolled hyperglycemia have significantly higher mortality rates.¹

“The coronavirus outbreak has stretched our hospitals and health systems to a point we’ve never experienced before, so it’s understandable that glycemic management may not have been a major point of focus thus far,” said Bruce Bode, MD, FACE, diabetes specialist at Atlanta Diabetes Associates, in a press release.²

Between February 12 and March 28, 2020, 7162 cases of COVID-19 were reported to the CDC with accompanying information on underlying health conditions. Based on those reports, diabetes was present in 24% of non-ICU and 32% of ICU patients with COVID-19.¹ Other research has found similar results, including a small retrospective study of 141 patients in Wuhan, China, which found diabetes present in 19% of cases.¹

In an effort to understand the effects of diabetes and hyperglycemia on patients with COVID-19, researchers conducted a retrospective observational study of laboratory-confirmed adults with COVID-19 between March 1 and April 6, 2020. They evaluated glycemic and clinical outcomes in patients with and without diabetes or acutely uncontrolled hyperglycemia.¹

Of the 1122 patients evaluated in 88 hospitals across the United States, 451 patients with either diabetes or uncontrolled hyperglycemia spent 37.8% of patient days with a mean blood glucose level greater than 180 mg/dl. At the time of analysis, 552 patients were still hospitalized. Of the 570 inactive patients, 77 had died, including 53 who were among the 184 patients in the combined diabetes and uncontrolled hyperglycemia group.¹

Among the 570 patients who either died or were discharged, the mortality rate was 28.8% among 184 patients with diabetes or uncontrolled hyperglycemia, compared with 6.2% of 386 patients without either condition. Specifically, among those 184 patients with diabetes or uncontrolled hyperglycemia, 40 of 96 patients with uncontrolled hyperglycemia died compared with 13 of 88 patients with diabetes.¹

Furthermore, among 493 discharged survivors, those with diabetes or uncontrolled hyperglycemia had a longer median length of stay in the hospital (5.7 days) compared with those without the conditions (4.3 days).¹

Of the 451 patients with diabetes and/or uncontrolled hyperglycemia, 59.4% were men, the median age was 65, and the median body mass index was 31.8 kg/m².¹

“These data may have wide implications for how we care for COVID-19 positive patients who experience hyperglycemia during their hospital stay or who have already been diagnosed with diabetes,” said senior author David Klonoff, MD, medical director of the Diabetes Research Institute, in a press release.²

The authors concluded that health care professionals should ensure that hyperglycemia and diabetes are safely and effectively treated in hospitalized patients with COVID-19 for their overall health, as well as for COVID-19 outcomes.¹

REFERENCES

• Bode B, Garrett V, Messler J, McFarland R, et al. Glycemic Characteristics and Clinical Outcomes of COVID-19 Patients Hospitalized in the United States [received via email]. Released April 17, 2020. Accessed April 16, 2020.
• COVID-19 Study Shows More than 4 Times In-Hospital Mortality Rate and Increased Length of Stay for Patients with Diabetes and Hyperglycemia [news release]. Glytec; received via email April 17, 2020. Accessed April 16, 2020.