tetano
Editor, Senior Moderator
J Diabetes Investig
. 2023 Jan 27.
doi: 10.1111/jdi.13979. Online ahead of print.
Association of acute-to-chronic glycemic ratio and outcomes in patients with COVID-19 and undiagnosed diabetes mellitus: A retrospective nationwide cohort study
Masaki Uchihara[SUP] 1 [/SUP], Takehiro Sugiyama[SUP] 2 3 4 [/SUP], Ryotaro Bouchi[SUP] 1 2 [/SUP], Nobuaki Matsunaga[SUP] 5 [/SUP], Yusuke Asai[SUP] 5 [/SUP], Hiroyuki Gatanaga[SUP] 6 [/SUP], Mitsuru Ohsugi[SUP] 1 2 [/SUP], Norio Ohmagari[SUP] 6 7 [/SUP], Hiroshi Kajio[SUP] 1 [/SUP], Kohjiro Ueki[SUP] 1 8 [/SUP]
Affiliations
Abstract
Aims/introduction: To assess the association of undiagnosed diabetes mellitus and its acute-to-chronic glycemic ratio with clinical outcome in patients hospitalized with coronavirus disease 2019 (COVID-19) using a large-scale nationwide registry in Japan.
Materials and methods: Overall, 4,747 patients were included between July 2021 and January 2022. We evaluated blood glucose and glycated hemoglobin levels at admission, and calculated the acute-to-chronic glycemic ratio for each non-diabetes mellitus, undiagnosed diabetes mellitus and pre-existing diabetes mellitus group. The primary composite outcome comprised in-hospital mortality, invasive mechanical ventilation, extracorporeal membrane oxygenation support, intensive care unit admission and transfer to a more advanced medical facility.
Results: Compared with the non-diabetes mellitus group, the undiagnosed diabetes mellitus group was significantly associated with a worse COVID-19 outcome (odds ratio 2.18, 95% confidence interval 1.50-3.18). In patients with undiagnosed diabetes mellitus, the 3rd tertile of the acute-to-chronic glycemic ratio was linked with a worse COVID-19 outcome compared with the 1st tertile (odds ratio 3.33, 95% confidence interval 1.43-7.77), whereas glycated hemoglobin levels were not; among patients with pre-existing diabetes mellitus, glycated hemoglobin levels were linked with a worse outcome.
Conclusions: Among patients with undiagnosed diabetes mellitus with COVID-19, the magnitude of elevation of blood glucose from chronic to acute levels is associated with worse outcomes.
Keywords: Acute-to-chronic glycemic ratio; COVID-19; Undiagnosed diabetes mellitus.
. 2023 Jan 27.
doi: 10.1111/jdi.13979. Online ahead of print.
Association of acute-to-chronic glycemic ratio and outcomes in patients with COVID-19 and undiagnosed diabetes mellitus: A retrospective nationwide cohort study
Masaki Uchihara[SUP] 1 [/SUP], Takehiro Sugiyama[SUP] 2 3 4 [/SUP], Ryotaro Bouchi[SUP] 1 2 [/SUP], Nobuaki Matsunaga[SUP] 5 [/SUP], Yusuke Asai[SUP] 5 [/SUP], Hiroyuki Gatanaga[SUP] 6 [/SUP], Mitsuru Ohsugi[SUP] 1 2 [/SUP], Norio Ohmagari[SUP] 6 7 [/SUP], Hiroshi Kajio[SUP] 1 [/SUP], Kohjiro Ueki[SUP] 1 8 [/SUP]
Affiliations
- PMID: 36708095
- DOI: 10.1111/jdi.13979
Abstract
Aims/introduction: To assess the association of undiagnosed diabetes mellitus and its acute-to-chronic glycemic ratio with clinical outcome in patients hospitalized with coronavirus disease 2019 (COVID-19) using a large-scale nationwide registry in Japan.
Materials and methods: Overall, 4,747 patients were included between July 2021 and January 2022. We evaluated blood glucose and glycated hemoglobin levels at admission, and calculated the acute-to-chronic glycemic ratio for each non-diabetes mellitus, undiagnosed diabetes mellitus and pre-existing diabetes mellitus group. The primary composite outcome comprised in-hospital mortality, invasive mechanical ventilation, extracorporeal membrane oxygenation support, intensive care unit admission and transfer to a more advanced medical facility.
Results: Compared with the non-diabetes mellitus group, the undiagnosed diabetes mellitus group was significantly associated with a worse COVID-19 outcome (odds ratio 2.18, 95% confidence interval 1.50-3.18). In patients with undiagnosed diabetes mellitus, the 3rd tertile of the acute-to-chronic glycemic ratio was linked with a worse COVID-19 outcome compared with the 1st tertile (odds ratio 3.33, 95% confidence interval 1.43-7.77), whereas glycated hemoglobin levels were not; among patients with pre-existing diabetes mellitus, glycated hemoglobin levels were linked with a worse outcome.
Conclusions: Among patients with undiagnosed diabetes mellitus with COVID-19, the magnitude of elevation of blood glucose from chronic to acute levels is associated with worse outcomes.
Keywords: Acute-to-chronic glycemic ratio; COVID-19; Undiagnosed diabetes mellitus.