Blood glucose levels in elderly subjects with type 2 diabetes during COVID-19 outbreak: a retrospective study in a single center

Xue, Ting; Li, Qian-wen; Zhang, Qiongyao; Lin, Wei; Wen, Junping; Li, Li; Chen, Gang

doi:10.1101/2020.03.31.20048579

Cited by 51 publications

(41 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The disease course in patients with COVID-19 can be perturbed by diabetes mellitus in two ways. On the one hand, diabetes is a risk factor for severe disease 3,[16][17][18][19][20][21][22] and, on the other, SARS-CoV-2 infection has been associated with altered glucose metabolism 3,16,24,29 . Specifically, ketosis and ketoacidosis were observed during and after SARS-CoV-2 infection, both being at least indirect clinical indicators of a lack of insulin due to β-cell loss or malfunction 18,[25][26][27][28][29][30] .…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 infects and replicates in cells of the human endocrine and exocrine pancreas

et al. 2021

View full text Add to dashboard Cite

Initially, the pandemic COVID-19, caused by SARS-CoV-2, was considered to be an exclusive lung disease, eventually leading to serious respiratory symptoms 1 . In the meantime, accumulating experimental and clinical studies have suggested that SARS-CoV-2 may also cause lesions in the kidneys, heart, brain, and gastrointestinal and endocrine organs [2][3][4][5][6][7] . SARS-CoV-2 tropism towards distinct tissues is governed by cellular factors expressed on target cells such as the viral entry receptor angiotensin-converting enzyme 2 (ACE2) 8 and the transmembrane serine protease 2 (TMPRSS2) 8 . ACE2 messenger RNA 9-13 and protein 12-14 expression within the islets of Langerhans has been reported, but not yet been shown, to allow SARS-CoV-2 entry 9,12,15 . Diabetes mellitus presents Janus like in 16 ): first, pre-existing diabetes is a highly prevalent comorbidity observed in 11-22% of patients and as such increases the risk of a severe disease, requiring more intense interventions and increasing mortality [17][18][19][20][21][22] . Second, SARS-CoV-2 infection seems to affect the exocrine pancreas, manifesting as pancreatitis in 32.5% of critically ill patients 23 , and pancreatic enlargement and abnormal amylase or lipase levels in 7.5-17% of patients 9,22 . Third, metabolic dysregulation has been observed in patients with COVID-19 as:(1) increased hyperglycaemia in patients with type 2 diabetes 24 ; (2) ketoacidosis in 2-6.4% of diabetic and non-diabetic patients 18,25 ; and (3), in case studies reporting ketoacidosis on SARS-CoV-2 infection, accompanied by (4) new-onset type 1 diabetes mellitus (T1DM) in the absence of autoantibodies [26][27][28] . In a cohort study of patients with diabetes, hyperglycaemia was reported in more than 50% of all cases, and almost a third experienced diabetic ketoacidosis 29 . Finally, a multicentre study found an 80% increase of new-onset T1DM in children during the COVID-19 pandemic 30 . In accordance, a recent meta-analysis summarizes that severe SARS-CoV-2 infects and replicates in cells of the human endocrine and exocrine pancreas

show abstract

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 infects and replicates in cells of the human endocrine and exocrine pancreas

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In turn, the presence of increased fasting blood glucose level > 126 mg/dl during the SARS infection was correlated with the increase in risk of death more than threefold [ 50 ]. The population particularly affected by the COVID-19 hyperglycemia are older people as demonstrated by Xue et al [ 51 ] as it seems that this population has an increased risk of hyperglycemia occurrence overall. Interestingly, a meta-analysis by Miller et al [ 52 ] revealed that the prevalence of diabetes increases the mortality, while comorbidities do not affect the overall number of deaths.…”

Section: Discussionmentioning

confidence: 99%

Impact of diabetes mellitus on in-hospital mortality in adult patients with COVID-19: a systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

Background The novel coronavirus disease 2019 (COVID-19) has spread worldwide since the beginning of 2020, placing the heavy burden on the health systems all over the world. The population that particularly has been affected by the pandemic is the group of patients suffering from diabetes mellitus. Having taken the public health in considerations, we have decided to perform a systematic review and meta-analysis of diabetes mellitus on in-hospital mortality in patients with COVID-19. Methods A systematic literature review (MEDLINE, EMBASE, Web of Science, Scopus, Cochrane) including all published clinical trials or observational studies published till December 10, 2020, was performed using following terms “diabetes mellitus” OR “diabetes” OR “DM” AND “survival” OR “mortality” AND “SARS-CoV-2” OR “COVID-19”. Results Nineteen studies were included out of the 7327 initially identified studies. Mortality of DM patients vs non-DM patients was 21.3 versus 6.1%, respectively (OR = 2.39; 95%CI: 1.65, 3.64; P < 0.001), while severe disease in DM and non-DM group varied and amounted to 34.8% versus 22.8% (OR = 1.43; 95%CI: 0.82, 2.50; P = 0.20). In the DM group, the complications were observed far more often when compared with non-DM group, both in acute respiratory distress (31.4 vs. 17.2%; OR = 2.38; 95%CI:1.80, 3.13; P < 0.001), acute cardiac injury (22.0% vs. 12.8%; OR = 2.59; 95%CI: 1.81, 3.73; P < 0.001), and acute kidney injury (19.1 vs. 10.2%; OR = 1.97; 95%CI: 1.36, 2.85; P < 0.001). Conclusions Based on the findings, we shall conclude that diabetes is an independent risk factor of the severity of COVID-19 in-hospital settings; therefore, patients with diabetes shall aim to reduce the exposure to the potential infection of COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s00592-021-01701-1.

show abstract

“…It was observed that infected elderly with diabetes had an elevated fasting blood glucose as opposed to their HbA1C which remained stable [66]. However, during the acute phase of the COVID-19 infection it is essential that strict glucose control is maintained to prevent the occurrence of complications [66,67].…”

Section: Glycemic Controlmentioning

confidence: 99%

The burden of type 2 diabetes pre-and during the COVID-19 pandemic – a review

Sciberras

Camilleri

Cuschieri

2020

J Diabetes Metab Disord

View full text Add to dashboard Cite

Introduction Diabetes Mellitus is a chronic disease and a global epidemic. It is a known fact that co-morbidities, including Diabetes Mellitus, pose a higher risk of infection by COVID-19. Additionally, the outcomes following infection are far worse than in people without such co-morbities. Factors contributing to the development of type 2 diabetes mellitus (T2DM) have long been established, yet this disease still bestows a substantial global burden. The aim was to provide a comprehensive review of the burden of diabetes pre-COVID-19 and the additional impact sustained by the diabetes population and healthcare systems during the COVID-19 pandemic, while providing recommendations of how this burden can be subsided. Methodology Literature searches were carried out on ‘Google Scholar’ and ‘PubMed’ to identify relevant articles for the scope of this review. Information was also collected from reliable sources such as the World Health Organisation and the International Diabetes Federation. Results T2DM presented with economic, social and health burdens prior to COVID-19 with an significant ‘Disability Adjusted Life Years’ impact. Whilst people with diabetes are more susceptible to COVID-19, enforcing lockdown regulations set by the Public Health department to reduce risk of infection brought about its own challenges to T2DM management. Through recommendations and adapting to new methods of management such as telehealth, these challenges and potential consequences of mismanagement are kept to a minimum whilst safeguarding the healthcare system. Conclusion By understanding the challenges and burdens faced by this population both evident pre-covid and during, targeted healthcare can be provided during the COVID-19 pandemic. Furthermore, implementation of targeted action plans and recommendations ensures the care provided is done in a safe and effective environment. Electronic supplementary material The online version of this article (10.1007/s40200-020-00656-4) contains supplementary material, which is available to authorized users.

show abstract

Blood glucose levels in elderly subjects with type 2 diabetes during COVID-19 outbreak: a retrospective study in a single center

Cited by 51 publications

References 22 publications

SARS-CoV-2 infects and replicates in cells of the human endocrine and exocrine pancreas

SARS-CoV-2 infects and replicates in cells of the human endocrine and exocrine pancreas

Impact of diabetes mellitus on in-hospital mortality in adult patients with COVID-19: a systematic review and meta-analysis

The burden of type 2 diabetes pre-and during the COVID-19 pandemic – a review

Contact Info

Product

Resources

About