In a new study, researchers found that patients hospitalized with COVID-19 have worse outcomes if they have high blood sugar, or hyperglycemia, regardless of whether they have diabetes.
They found that patients with COVID-19 who had hyperglycemia on admission to the hospital were more likely than those with normal glucose (sugar) to require a breathing machine or admission to the intensive care unit (ICU).
These patients also were reportedly likelier to have kidney injury and to die in the hospital.
The research was conducted by a team at the State University of New York.
In the study, the team tested 708 adults with COVID-19. About half were men, and 54% of patients had a history of either type 1 or type 2 diabetes on admission.
Because guidelines recommend that hospitalized patients with diabetes maintain blood glucose levels between 140 and 180 milligrams per deciliter (mg/dL), the team divided patients into groups by glucose levels less than 140 and less than 180 mg/dL.
They found patients with diabetes whose blood glucose values on admission exceeded 140 mg/dL had a 2.4-fold increased odds of ICU admission and intubation—needing a breathing machine—versus those whose glucose levels were lower.
Furthermore, patients with diabetes whose admission glucose levels were higher than 180 mg/dL had about twofold increased odds of in-hospital death.
However, the odds of death also were increased twofold for patients who did not have diabetes and whose glucose values exceeded 140 mg/dL.
Additionally, these patients had a 3.5-fold raised odds of ICU admission and a 2.3-fold higher odds of intubation and of experiencing acute kidney injury.
According to the team, patients without diabetes whose blood glucose levels topped 180 mg/dL had a fourfold greater death risk, a nearly threefold increased odds of ICU admission, and a 2.7-fold higher odds of intubation.
The results suggest the importance of regularly monitoring blood glucose in patients hospitalized with COVID-19, even without a prior diagnosis of diabetes.
It is unclear whether hyperglycemia is the result of or a cause of more severe COVID-19 illness.
Still, the results suggest the need for intensive glucose control in hospitalized COVID-19 patients with high blood sugar.
The study was presented at ENDO 2021. One author of the study is Samara Skwiersky, M.D., M.P.H.
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