Diabetes patients using Insulin have high mortality with COVID 19 infection

The increased mortality rate was seen in type 2 Diabetic Patients who are on home insulin suffering from COVID pneumonia than in patients who are on oral antihyperglycemic drugs. The study was published in Diabetology & Metabolic Syndrome, 2022.

COVID 19 pandemic has caused great havoc on mankind. Risk factors like diabetes, cardiovascular diseases, and immunocompromised state have been associated with worse outcomes and sometimes death in some individuals. But there is no evident information that all group of diabetics shares the same risk of complications with COVID-19 infection. Researchers conducted a study to compare disease severity and mortality rate in insulin users versus non-insulin users.

A retrospective case-control study was conducted at the largest health care network in New York state from March 2020 to October 2020. It included adult, diabetic patients admitted with Covid-19 pneumonia. The baseline characteristics and outcomes of diabetic patients on home insulin as cases and non-insulin user diabetics as controls were compared. A Cox regression analysis was done to determine if home insulin use is associated with increased mortality.

The following are the key findings of the study:

• 696 patients were included with a median age of 57 years, interquartile range [IQR] 51–62, and median body mass index of 29.9 (IQR: 26–34.7).
• The majority (476 [68%]) were males with 227 cases (33%) and 469 controls (67%).
• More cases than controls were hypertensive (74% vs 67%, p = 0.03), on ACE/ARB (50% vs 42%, p = 0.05), and had a hemoglobin A1c > 8.1 (71% vs 44%, p < 0.001).
• More cases had AKI (52% vs 38%, p < 0.001), however, no significant differences were found in intubation rates (26% vs 24%, p = 0.54), detection of pulmonary embolism (4% vs 6%, p = 0.19) or death rate (15% vs 11%, p = 0.22) comparing cases and controls.
• In a multivariate analysis, home insulin use was independently associated with an increased risk of death (Hazard ratio: 1.92, 95% confidence interval (1.13–3.23)).

Thus, the researchers concluded that diabetic patients on home insulin with COVID-19 pneumonia, have worse outcomes and increased mortality compared to diabetics on oral antihyperglycemic agents. They further suggested,  close monitoring of insulin-dependent type II diabetic patients considering the current pandemic situation.  

To read the full article, click here: https://doi.org/10.1186/s13098-022-00857-2