Unmanaged Diabetes Linked to More Severe COVID-19, Longer Stays in Hospital

Conference | <b>American Diabetes Association</b>

While investigators found no differences in outcomes based on diabetes status alone, results indicated those who were not managing their diabetes had more severe outcomes and longer length of hospitalization from COVID-19.

New research presented at the American Diabetes Association 81st Scientific Sessions (ADA 2021) suggests those with poor diabetes management were at a greater risk of severe COVID-19 outcomes.

A retrospective look at data from more than 350 patients admitted to a single medical center in Texas, results indicate there was no difference in outcomes based on diabetes status alone, but those with unmanaged diabetes had more severe COVID-19 and a slower rate of recovery than their counterparts with more effective diabetes management.

“Our results highlight the importance of assessing, monitoring, and controlling blood glucose in hospitalized COVID-19 patients from the start, specifically for vulnerable populations already at risk of comorbidities,” said lead investigator Sudip Bajpeyi, PhD, Director of Metabolic Nutrition and Exercise Research at University of Texas at El Paso, in a statement.

With an interest in describing the differences in outcomes and disease course among patients with diabetes, Bajpeyi and a team of colleagues from the University of Texas at El Paso designed their study as a retrospective analysis of data from patients admitted to the University Medical Center in El Paso, TX. Overall, 369 patients were identified for analysis. This group had a mean age of 60.15±0.8 years and a mean BMI of 30.28±0.4 kg/m2, and 243 had diabetes.

Patients were categorized according to HbA1c level at time of hospitalization. These groups were defined as normoglycemic (HbA1c less than 5.7%), prediabetes (5.7% to less than 6.5%), and diabetes mellitus (6.5% or greater). For the purpose of analysis, investigators assessed the severity of COVID-19 outcomes through quick sepsis-related organ failure assessment (qSOFA) and length of hospitalization was measured as number of days spent inside the hospital. Investigators also noted plans for further assessment within the diabetes mellitus group according to medication use.

Upon analysis, results indicated there were no significant differences observed among groups for severity of COVID-19 infection, with a qSOFA scores of 0.24±0.08, 0.38±0.07, and 0.28±0.03, respectively, for the normoglycemic, prediabetes, and diabetes mellitus groups (P >.05). Additionally, no significant differences were observed when elating potential differences in length of hospitalization with mean lengths of stay of 5.6±0.8, 9.3±1.0, and 8.9±0.6 days, respectively, among the normoglycemic, prediabetes, and diabetes mellitus groups (P >.05).

However, results indicated patients with diabetes not using medication appeared to have significantly greater severity (qSOFA: 0.44±0.08 vs 0.22±0.03; P <.05) and length of hospitalization (10.8±1.6 vs 8.2±0.6 days; P <.05) compared to patients managing their diabetes with medication.

This study, “Unmanaged Diabetes as a Poor Prognostic Factor in the Severity of Infection and Recovery Time of Hospitalized COVID-19 Patients,” was presented at ADA 2021.