A strong link has been observed between glucose control and COVID-19 outcomes among hospitalized patients with preexisting T2D. One study involving 952 patients with COVID-19 and T2D showed that well-controlled blood glucose was associated with reduced risk for all-cause mortality and detrimental complications. Patients with "poorly controlled" blood glucose (n = 528), defined as the lowest fasting glucose level ≥ 3.9 mmol/L and the highest 2-hour postprandial glucose > 10 mmol/L (median, 10.9 mmol/L [196 mg/dL]) and A1c level of 8.1% had a higher mortality rate. It is now known that poor glucose control prior to hospitalization can be associated with a high risk for in-hospital death.
A retrospective study by Chen and colleagues of patients with COVID-19 and T2D found that older age, elevated C-reactive protein level, and insulin use were risk factors for mortality. Whether insulin itself is a risk factor or whether the increased mortality reflects the characteristics of the patients taking it is unclear.
Women taking metformin may be at lower risk for fatal COVID-19. In a study involving more than 6200 adults with diabetes or obesity who were hospitalized for COVID-19, fewer deaths were reported among women who had filled their 90-day metformin prescriptions. After adjustment for other risk factors, these women were 21%-24% less likely to die of COVID-19. This link was not observed among men. However, a multicenter observational study in France showed that metformin reduces the risk for COVID-related mortality in hospitalized patients, regardless of sex.
Although the risk for death from COVID-19 is significantly increased in people with both main types of diabetes, early findings suggest that the highest risk is associated with T1D.
Learn more about COVID-19 and diabetes.
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Cite this: Romesh Khardori, Anne L. Peters. Fast Five Quiz: Type 2 Diabetes Key Aspects - Medscape - Dec 15, 2022.