Diabetes had been one of the pre-existing health conditions associated with a higher risk of death for patients with coronavirus. However, new medical research has discovered that coronavirus had given some patients without a history of diabetes symptoms of high blood sugar, also increasing their risk of severe complications and death.
A collaboration between Union Hospital, Huazhong University of Science and Technology, and Tongji Medical College in Wuhan, China recently published their findings in the European Association for the Study of Diabetes journal Diabetologia. To begin, they analyzed previous data that established that patients with hyperglycemia, or high blood sugar, had major health risks when getting infected with coronavirus.
Several risks of high blood sugar resulted in pneumonia, heart attack, stroke, trauma, surgery, and other medical complications. The team looked to establish a link between fasting blood glucose (FBG) level at the time of diagnosis and the progression of patients without diabetes.
Patients Without Diabetes
Clinical data for patients admitted in Wuhan from January to February were tested for CRB-65, a tool that assesses the severity of community-acquired pneumonia which helps segregate patients. The severity of pneumonia included four indicators: level of confusion, respiratory rate, blood pressure, and age.
605 patients enrolled in the study where 208 had underlying conditions, excluding diabetes. 29% of the patients had a high FBG level and consistently resulted in the diagnosis of type 2 diabetes. Moreover, 17% had blood levels considered to be pre-diabetic.
Further conclusions included those with middle blood sugar levels or pre-diabetic who had a 71% likely chance of dying than those in the lowest group. 75% of men were more likely to die than women. Combining both FBG and CRB65 scores ruled out who were at the highest risk of death.
The authors noted, 'This study shows, for the first time, that elevated FBG [levels] at admission is independently associated with increased 28-day mortality and percentages of in-hospital complications in COVID-19 patients without a previous diagnosis of diabetes... we have also shown that FBG of 7.0 mmol/l or higher is associated with increased mortality, regardless of whether the patient has pneumonia that is more or less severe.'
Blood Sugar Testing
They also explained that some of the people were undiagnosed diabetic and non-diabetic patients with hyperglycemia who had an acute blood-glucose disorder. Coronavirus patients would sometimes show high levels of blood sugar due to other conditions while some severe cases resulted in acute insulin resistance.
'In conclusion, a fasting blood glucose level of 7.0 mmol/l or higher at admission is an independent predictor for 28-day mortality in patients with COVID-19 without a previous diagnosis of diabetes. Blood sugar testing and control should be recommended to all COVID-19 patients even if they do not have pre-existing diabetes, as most COVID-19 patients are prone to glucose metabolic disorders,' noted the authors. They advise doctors to consider 'measuring fasting blood glucose [which] can facilitate the assessment of prognosis and early intervention of hyperglycemia to help improve the overall outcomes in the treatment of COVID-19.'
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