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Thresholds of Glycemia and the Outcomes of COVID-19 Complicated With Diabetes: A Retrospective Exploratory Study Using Continuous Glucose Monitoring.

Authors
  • Shen, Yun1
  • Fan, Xiaohong2
  • Zhang, Lei1
  • Wang, Yaxin1
  • Li, Cheng1
  • Lu, Jingyi1
  • Zha, Bingbing3
  • Wu, Yueyue3
  • Chen, Xiaohua4
  • Zhou, Jian5
  • Jia, Weiping5
  • 1 Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. , (China)
  • 2 Department of Pulmonary Medicine and Critical Care, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. , (China)
  • 3 Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China. , (China)
  • 4 Department of Infectious Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. , (China)
  • 5 Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China [email protected] [email protected] , (China)
Type
Published Article
Journal
Diabetes care
Publication Date
Feb 11, 2021
Identifiers
DOI: 10.2337/dc20-1448
PMID: 33574126
Source
Medline
Language
English
License
Unknown

Abstract

Although elevated glucose levels are reported to be associated with adverse outcomes of coronavirus disease 2019 (COVID-19), the optimal range of glucose in patients with COVID-19 and diabetes remains unknown. This study aimed to investigate the threshold of glycemia and its association with the outcomes of COVID-19. Glucose levels were assessed through intermittently scanned continuous glucose monitoring in 35 patients for an average period of 10.2 days. The percentages of time above range (TAR), time below range (TBR), time in range (TIR), and coefficient of variation (CV) were calculated. Composite adverse outcomes were defined as either the need for admission to the intensive care unit, need for mechanical ventilation, or morbidity with critical illness. TAR using the threshold of 160-200 mg/dL was significantly associated with composite adverse outcomes after adjustment of covariates. Both TBR (<70 mg/dL) and TIR (70-160 mg/dL), but not mean sensor glucose level, were significantly associated with composite adverse outcomes and prolonged hospitalization. The multivariate-adjusted odds ratios of the CV of sensor glucose across tertiles for composite adverse outcomes of COVID-19 were 1.00, 1.18, and 25.2, respectively. Patients with diabetes and COVID-19 have an increased risk of adverse outcomes with glucose levels >160 mg/dL and <70 mg/dL and a high CV. Therapies that improve these metrics of glycemic control may result in better prognoses for these patients. © 2021 by the American Diabetes Association.

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