Well controlled blood sugar in diabetics with Covid 19 improves survival

It is well known that diabetes status increased the need for medical interventions during COVID-19 epidemic and Diabetes status increased the mortality risk of patients with COVID-19.However, the impact of blood sugar control on the degree of required medical interventions and on mortality in patients with COVID-19 and T2D remains uncertain

Researchers have found in a retrospective study that well-controlled blood sugar correlated with improved outcomes in Covid 19 infected patients. The largest study till now has re-affirmed better blood sugar control and improved COVID-19 outcomes in hospitalized patients with pre-existing type 2 diabetes.

Dr Lihua Zhu at Renmin Hospital of Wuhan University, China, and colleagues have reported the study that has been published online in Cell Metabolism.

The researchers conducted the study in Hubei Province, China in a cohort of 7,337 COVID-19 patients with or without diabetes. Out of total number of cases 952 had pre-existing T2D.

Among the 952 with COVID-19 and type 2 diabetes, 282 individuals had "well-controlled" blood sugar, ranging from 3.9 to 10.0 mmol/L (~70 - 180 mg/dl) with median 6.4 mmol/L (115 mg/dL) and hemoglobin A1c of 7.3%.At the same time the other 528 had "poorly controlled," blood sugar.

They 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, they found that well-controlled blood sugar (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.

The researchers concluded that although type 2 diabetes is a risk factor for worse COVID-19 outcomes, better blood sugar control among those with pre-existing type 2 diabetes may be associated with significant reductions in adverse outcomes and death.

"Considering that people with diabetes had much higher risk for death and various complications, and there are no specific drugs for COVID-19, our findings indicate that controlling blood glucose well may act as an effective auxiliary approach to improve the prognosis of patients with COVID-19 and pre-existing diabetes," the author added.

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DOI:https://doi.org/10.1016/j.cmet.2020.04.021