Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes

Zhu, Lihua; She, Zhi-Gang; Cheng, Xu; Qin, Juan-Juan; Zhang, Xiao-Jing; Cai, Jingjing; Lei, Fang; Wang, Haitao; Xie, Jing; Wang, Wenxin; Li, Haomiao; Zhang, Peng; Song, Xiaohui; Chen, Xi; Xiang, Mei; Zhang, Chaozheng; Bai, Liangjie; Xiang, Da; Chen, Ming-Ming; Liu, Yanqiong; Yan, Youqin; Liu, Mingyu; Mao, Weiming; Zou, Jinjing; Liu, Liming; Chen, Guohua; Luo, Pengcheng; Xiao, Bing; Zhang, Changjiang; Zhang, Zixiong; Lu, Zhigang; Wang, Junhai; Lu, Haofeng; Xia, Xigang; Wang, Daihong; Liao, Xiaofeng; Peng, Gang; Ye, Ping; Yang, Jun; Yuan, Yufeng; Huang, Xiaodong; Guo, Jiao; Zhang, Bing-Hong; Li, Hongliang

Type 2 diabetes (T2D) is a major comorbidity of COVID-19. However, the impact of blood glucose (BG) control on the degree of required medical interventions and on mortality in patients with COVID-19 and T2D remains uncertain. Thus, we performed a retrospective, multi-centered study of 7,337 cases of COVID-19 in Hubei Province, China, among which 952 had pre-existing T2D. We found that subjects with T2D required more medical interventions and had a significantly higher mortality (7.8% versus 2.7%; adjusted hazard ratio [HR], 1.49) and multiple organ injury than the non-diabetic individuals. Further, we found that well-controlled BG (glycemic variability within 3.9 to 10.0 mmol/L) was associated with markedly lower mortality compared to individuals with poorly controlled BG (upper limit of glycemic variability exceeding 10.0 mmol/L) (adjusted HR, 0.14) during hospitalization. These findings provide clinical evidence correlating improved glycemic control with better outcomes in patients with COVID-19 and pre-existing T2D.