Friday , September 30 2022

Blood Sugar Fluctuations Affect Patients with COVID-19 Diabetes



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Author: Oluwatayo Ishola, PharmD. Candidate, South College, School of Pharmacy

Blood sugar levels between 70 and 160 mg / dL are considered normal, and anything beyond this level can adversely affect patients with diabetes and COVID-19.

According to a study in China, extensive changes in glucose levels increase the risk of developing adverse effects in patients diagnosed with coronavirus and diabetes. The study was conducted by monitoring the blood sugar of patients with diabetes and coronavirus during hospitalization in Wuhan, China (where the pandemic began). Therefore, it is recommended to start drug treatment in patients with COVID-19 and diabetes with blood glucose levels less than 70 or more than 160. The goal of starting therapy is to bring the patient’s glucose back to normal, thereby increasing and decreasing his chances. risk of developing adverse effects.

When looking at patients’ A1c levels, the researchers found that these levels could not be a good reference for coronavirus outcomes. A1c may appear normal in test results, although not in patients with regular hypoglycemia and hyperglycemia. A1c is not a good measure of glycemic fluctuations due to the potential for a false normal result. Only blood sugar levels should be measured and used when monitoring patients for glucose variability.

The study was small and included 35 diabetic patients. These patients were hospitalized after being diagnosed with coronavirus. Patients were observed with intermittent scanned continuous glucose monitoring (also known as isCGM). Of the 35 patients who participated in the study, 15 were either critically ill, either admitted to the intensive care unit or wearing a ventilator. None of the patients died. Patients who met the composite outcome criterion had higher blood sugar levels between 140 and 200 mg / dL than other patients. Patients who met the composite outcome criteria spent 52.1 percent of their stay with blood glucose levels above 160 mg / dL, and those who did not pass 29.8 percent of hospitalizations spent more than 160 mg / dL. The group of patients who met the composite outcome criterion spent time with blood sugar levels below 70 compared to those who did not meet the criterion.

Adjustments had to be made for many patient factors. Factors that required correction were glucocorticoid use, age, body mass index, sex, symptoms when taken, and blood pressure. Once the researchers corrected the study, a time between 160 and 200 mg / dL and below 70 mg / dL was directly associated with an increased risk of coronavirus adverse association outcomes and the risk of hospitalization. The average length of hospital stay was more than one month for patients who reached the previously indicated limits. Patients with composite results also experienced higher mean glucose levels than those seen with isCGM. With all the data presented, there was no statistical significance between glucose levels and negative composite outcomes in patients with diabetes and COVID-19.

It is believed that the increased risk of adverse outcomes in patients with diabetes and coronavirus is due to abnormal humoral immunity, decreased T cell function, and dysfunctional neutrophils. Because patients with diabetes are at high risk for COVID-19-related side effects, they should do everything possible to avoid contracting the disease. In addition to regular COVID-19 measures such as wearing a mask, social exclusion, and hand washing, patients should also manage their illness to reduce their risks. Patients should continue to have their blood sugar checked regularly, follow medication regimens, exercise regularly, and maintain a healthy weight and diet.

Apply pearls:

  • Patients with diabetes with blood sugar levels below 70 mg / dL and above 160 mg / dL have a higher risk of adverse outcomes due to COVID-19.
  • Researchers believe that the risk of adverse outcomes in patients with diabetes and coronavirus is due to increased risk, abnormal humoral immunity, decreased T-cell function, and dysfunctional neutrophils.
  • Patients with diabetes should continue to manage their condition well to reduce the risks associated with COVID-19.

Miriam E. Tucker. Extensive Glucose Change Equally Weak COVID-19 Results in Inpatients with Diabetes Hospitals. Medscape, 25 February 2021.

Yun Sen, Xiaohong Fan, Glycemic Threshold and Diabetes Complicated COVID-19 Results: A Retrospective Intelligence Study Using Continuous Glucose Monitoring. American Diabetes Association, February 2021.

Oluwatayo Ishola, PharmD. Candidate, South College, School of Pharmacy

Learn more about diabetes and COVID-19.

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