Impact of glycemic control in diabetes mellitus on management of COVID-19 infection
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ORIGINAL ARTICLE
Impact of glycemic control in diabetes mellitus on management of COVID-19 infection Sudhir Bhandari 1 & Govind Rankawat 1
&
Ajeet Singh 1 & Vishal Gupta 1 & Shivankan Kakkar 2
Received: 8 June 2020 / Accepted: 24 August 2020 # Research Society for Study of Diabetes in India 2020
Abstract Background Diabetes mellitus may be associated with increased severity and enhanced mortality in COVID-19 infections. The present study was undertaken to evaluate the clinical presentation, laboratory parameters, radiological imaging, management, and outcome of COVID-19 infection in patients of diabetes mellitus and its association with glycemic control. Methods The present study was designed to evaluate the difference between uncontrolled and controlled diabetes for COVID-19 manifestations by enrolling 80 admitted COVID-19 patients. Patients were categorized into two groups, where group 1 had patients with uncontrolled diabetes as indicated by HbA1c > 8 g% and group 2 had patients with controlled diabetes as indicated by HbA1c < 8 g%. Information concerning medical history, clinical manifestations, laboratory findings, radiological imaging, management, and outcome was extracted from medical records for evaluation, interpretation, and association among both the groups. Results COVID-19 patients with uncontrolled diabetes exhibited a severe symptomatic presentation, excessive uncontrolled inflammatory responses, and hypercoagulable state. Total leukocyte count, neutrophil-lymphocyte ratio, serum levels of IL-6, FDP, and Ddimer were significantly raised (p < 0.05) in case of uncontrolled diabetes as compared with controlled diabetes. Radiological findings detected by chest radiograph and computed tomography chest suggested severe lung involvement in uncontrolled diabetes. COVID-19 patients with uncontrolled diabetes required intensive treatment as compared with controlled diabetes group in terms of insulin therapy (p = 0.0226) and non-invasive ventilation (p = 0.0292). Patients with uncontrolled diabetes had higher mortality (p = 0.0375) and required prolonged hospitalization (p = 0.0479) as compared with controlled diabetes group. Conclusion From the current study, it can be concluded that uncontrolled diabetic condition might be a risk factor for severity and morbidity of COVID-19 patients. Uncontrolled diabetes mellitus might be responsible for an overall higher susceptibility for COVID-19 infection and severity in terms of symptomatic presentation, inflammatory storm, rapid pulmonary invasion, requirement of more intensive treatment, and a poor outcome. Keywords COVID-19 . Diabetes mellitus . HbA1c . Glycemic control . Management
* Govind Rankawat [email protected] Sudhir Bhandari [email protected] Ajeet Singh [email protected] Vishal Gupta [email protected] Shivankan Kakkar [email protected] 1
Department of General medicine, SMS Medical College and Attached Group of Hospital, Jaipur, Rajasthan, India
2
Department of Pharmacology, SMS Medical College and Attached Group
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