Impact of undiagnosed type 2 diabetes and pre-diabetes on severity and mortality for SARS-CoV-2 infection
| Autor: | María F González-Lara, Carlos A. Aguilar-Salinas, Edgar Ortiz-Brizuela, Jessica Paola Bahena-López, Alejandro Campos-Muñoz, Arsenio Vargas-Vázquez, José Sifuentes-Osornio, Marco Villanueva-Reza, Alfredo Ponce de León, Roopa Mehta, Neftali Eduardo Antonio-Villa, Omar Yaxmehen Bello-Chavolla |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Research design
Adult Blood Glucose Male medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Endocrinology Diabetes and Metabolism Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Type 2 diabetes Severity of Illness Index Undiagnosed Diseases Diseases of the endocrine glands. Clinical endocrinology Cohort Studies Prediabetic State Risk Factors Internal medicine Diabetes mellitus Severity of illness medicine Humans Prospective Studies Prospective cohort study Pathophysiology/Complications Mexico Glycated Hemoglobin business.industry SARS-CoV-2 COVID-19 Fasting Middle Aged medicine.disease RC648-665 Hospitalization type 2 Diabetes Mellitus Type 2 diabetes mellitus Female hyperglycemia business Cohort study |
| Zdroj: | BMJ Open Diabetes Research & Care, Vol 9, Iss 1 (2021) BMJ Open Diabetes Research & Care |
| ISSN: | 2052-4897 |
| Popis: | IntroductionDiabetes and hyperglycemia are risk factors for critical COVID-19 outcomes; however, the impact of pre-diabetes and previously unidentified cases of diabetes remains undefined. Here, we profiled hospitalized patients with undiagnosed type 2 diabetes and pre-diabetes to evaluate its impact on adverse COVID-19 outcomes. We also explored the role of de novo and intrahospital hyperglycemia in mediating critical COVID-19 outcomes.Research design and methodsProspective cohort of 317 hospitalized COVID-19 cases from a Mexico City reference center. Type 2 diabetes was defined as previous diagnosis or treatment with diabetes medication, undiagnosed diabetes and pre-diabetes using glycosylated hemoglobin (HbA1c) American Diabetes Association (ADA) criteria and de novo or intrahospital hyperglycemia as fasting plasma glucose (FPG) ≥140 mg/dL. Logistic and Cox proportional regression models were used to model risk for COVID-19 outcomes.ResultsOverall, 159 cases (50.2%) had type 2 diabetes and 125 had pre-diabetes (39.4%), while 31.4% of patients with type 2 diabetes were previously undiagnosed. Among 20.0% of pre-diabetes cases and 6.1% of normal-range HbA1c had de novo hyperglycemia. FPG was the better predictor for critical COVID-19 compared with HbA1c. Undiagnosed type 2 diabetes (OR: 5.76, 95% CI 1.46 to 27.11) and pre-diabetes (OR: 4.15, 95% CI 1.29 to 16.75) conferred increased risk of severe COVID-19. De novo/intrahospital hyperglycemia predicted critical COVID-19 outcomes independent of diabetes status.ConclusionsUndiagnosed type 2 diabetes, pre-diabetes and de novo hyperglycemia are risk factors for critical COVID-19. HbA1c must be measured early to adequately assess individual risk considering the large rates of undiagnosed type 2 diabetes in Mexico. |
| Databáze: | OpenAIRE |
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