Cell Metabolism
Volume 31, Issue 6, 2 June 2020, Pages 1068-1077.e3
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Clinical and Translational Report
Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes

https://doi.org/10.1016/j.cmet.2020.04.021Get rights and content
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Highlights

  • 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

Summary

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
diabetes mellitus
blood glucose control
mortality

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These authors contributed equally

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