Newly Diagnosed Diabetes in Patients with COVID-19: Different Types and Short-Term Outcomes

Farag, Ahmed; Hassanin, Hassan; Soliman, Hanan; Sallam, Ahmad Soliman; Sediq, Amany; Elbaser, Elsayed Saad Abd; Elbanna, Khaled Ahmed Ahmed

doi:10.3390/tropicalmed6030142

Cited by 27 publications

(42 citation statements)

References 24 publications

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“…We found that patients with newly diagnosed diabetes had higher levels of HbA1c and inflammatory markers, including CRP and LDH, and required more oxygen on admission than patients with pre‐existing diabetes. Overall, the present results were consistent with previous reports showing that newly diagnosed diabetes is associated with a higher risk of patients being critically ill with COVID‐19 4,13–15 .…”

Section: Discussionsupporting

confidence: 93%

Impact of newly diagnosed diabetes on coronavirus disease 2019 severity and hyperglycemia

Uchihara

Bouchi

Kodani

et al. 2022

J of Diabetes Invest

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Aims/Introduction Diabetes is associated with poor clinical outcomes of coronavirus disease 2019 (COVID‐19). However, the impact of newly diagnosed diabetes on prognosis has not been clarified. The objective of this study was to show the features and outcome of COVID‐19 patients with newly diagnosed diabetes in Japan. Materials and Methods We retrospectively analyzed 62 patients with diabetes hospitalized for COVID‐19 between 1 April and 18 August 2021 at the National Center for Global Health and Medicine in Tokyo, Japan. We evaluated the worst severity of COVID‐19 and plasma blood glucose levels in patients with newly diagnosed diabetes or pre‐existing diabetes. Results This study included 62 confirmed COVID‐19 patients with diabetes, including 19 (30.6%) patients with newly diagnosed diabetes and 43 (69.4%) patients with pre‐existing diabetes. Patients with newly diagnosed diabetes significantly progressed to a critical condition more frequently during hospitalization than patients with pre‐existing diabetes (52.6% vs 20.9%, P = 0.018). In addition, patients with newly diagnosed diabetes had significantly higher average plasma blood glucose levels for the first 3 days after admission than those with pre‐existing diabetes. Conclusions Our study suggests that the proportion of COVID‐19 patients who are newly diagnosed with diabetes is high, and they have an increased risk of developing severe disease than those with pre‐existing diabetes. It might be advisable that at the point of COVID‐19 diagnosis, blood glucose and glycated hemoglobin levels be assessed in all patients.

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Section: Discussionsupporting

confidence: 93%

Impact of newly diagnosed diabetes on coronavirus disease 2019 severity and hyperglycemia

Uchihara

Bouchi

Kodani

et al. 2022

J of Diabetes Invest

View full text Add to dashboard Cite

show abstract

“…Larger and more focused studies are recommended to further elucidate its effect on diabetes and COVID-19 outcomes. Newly diagnosed diabetes amongst COVID-19 patients conferred a higher risk of adverse outcomes, according to some studies ( 28 , 29 ). However, the very small number of this subgroup in this cohort makes it difficult to draw any significant conclusion from it.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of COVID-19 Patients in a Regional Population With Diabetes Mellitus: The ACCREDIT Study

et al. 2022

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ObjectiveTo identify clinical and biochemical characteristics associated with 7- & 30-day mortality and intensive care admission amongst diabetes patients admitted with COVID-19.Research Design and MethodsWe conducted a cohort study collecting data from medical notes of hospitalised people with diabetes and COVID-19 in 7 hospitals within the Mersey-Cheshire region from 1 January to 30 June 2020. We also explored the impact on inpatient diabetes team resources. Univariate and multivariate logistic regression analyses were performed and optimised by splitting the dataset into a training, test, and validation sets, developing a robust predictive model for the primary outcome.ResultsWe analyzed data from 1004 diabetes patients (mean age 74.1 (± 12.6) years, predominantly men 60.7%). 45% belonged to the most deprived population quintile in the UK. Median BMI was 27.6 (IQR 23.9-32.4) kg/m2. The primary outcome (7-day mortality) occurred in 24%, increasing to 33% by day 30. Approximately one in ten patients required insulin infusion (9.8%). In univariate analyses, patients with type 2 diabetes had a higher risk of 7-day mortality [p < 0.05, OR 2.52 (1.06, 5.98)]. Patients requiring insulin infusion had a lower risk of death [p = 0.02, OR 0.5 (0.28, 0.9)]. CKD in younger patients (<70 years) had a greater risk of death [OR 2.74 (1.31-5.76)]. BMI, microvascular and macrovascular complications, HbA1c, and random non-fasting blood glucose on admission were not associated with mortality. On multivariate analysis, CRP and age remained associated with the primary outcome [OR 3.44 (2.17, 5.44)] allowing for a validated predictive model for death by day 7.ConclusionsHigher CRP and advanced age were associated with and predictive of death by day 7. However, BMI, presence of diabetes complications, and glycaemic control were not. A high proportion of these patients required insulin infusion warranting increased input from the inpatient diabetes teams.

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“…Although children have lower rates of COVID-19 mortality, the presence of preexisting conditions such as diabetes can heighten the severity of their clinical presentations. Studies in adults have shown new-onset diabetes as well as expression of preexisting diabetes in a significant proportion of patients with COVID-19, both presenting with more severe infection [ 2 ]. Another study discussing the effect of the pandemic on adults with diabetes showed increases in diabetes-related stress, higher in young adults with type 2 diabetes (T2D) compared with older adults [ 3 ].…”

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confidence: 99%

Pediatric Diabetes on the Rise: Trends in Incident Diabetes During the COVID-19 Pandemic

Modarelli

Sarah

Ramaker

et al. 2022

Journal of the Endocrine Society

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Context The effects of the COVID-19 pandemic on the incident cases of pediatric Type 1 (T1D) and Type 2 diabetes (T2D) are not clear. Objective To identify trends in incidence and presentation of pediatric new-onset T1D and T2D during the COVID-19 pandemic. Methods A retrospective chart review was conducted. Demographics, anthropometrics, and initial labs from patients ages 0-21 who presented with new-onset diabetes to a pediatric tertiary care center were recorded. Results During the pandemic incident cases of pediatric T1D increased from 31 in each of the prior two years to 46; an increase of 48%. Incident cases of pediatric T2D increased by 231% from 2019 to 2020. The number of incident cases of pediatric T2D increased significantly more than the number of incident cases of pediatric T1D (p-value = 0.009). Patients with T2D were more likely to present in DKA, though this was not statistically significant (p-value=0.093). Severe DKA was higher compared to moderate DKA (p-value = 0.036) in incident cases of pediatric T2D. During the pandemic, for the first time, incident cases of T2D accounted for more than half of the all newly diagnosed pediatric diabetes cases (53%). Conclusions There were more incident pediatric T1D and T2D cases as well as an increase in DKA severity in T2D at presentation during the COVID-19 pandemic. More importantly, incident T2D cases were higher than the incident T1D during the pandemic. This clearly suggests a disruption and change in the pediatric diabetes trends with profound individual and community health consequences.

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Newly Diagnosed Diabetes in Patients with COVID-19: Different Types and Short-Term Outcomes

Cited by 27 publications

References 24 publications

Impact of newly diagnosed diabetes on coronavirus disease 2019 severity and hyperglycemia

Impact of newly diagnosed diabetes on coronavirus disease 2019 severity and hyperglycemia

Clinical Characteristics of COVID-19 Patients in a Regional Population With Diabetes Mellitus: The ACCREDIT Study

Pediatric Diabetes on the Rise: Trends in Incident Diabetes During the COVID-19 Pandemic

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