| Autor: |
Omar Yaxmehen Bello-Chavolla, Jessica Paola Bahena-López, Arsenio Vargas-Vázquez, Neftali Eduardo Antonio-Villa, Roopa Mehta, Carlos Alberto Aguilar-Salinas, Edgar Ortiz-Brizuela, Alejandro Campos-Muñoz, Marco Villanueva-Reza, María Fernanda González-Lara, Alfredo Ponce de León, Jose Sifuentes-Osornio |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
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| Zdroj: |
BMJ Open Diabetes Research & Care, Vol 9, Iss 1 (2021) |
| Druh dokumentu: |
article |
| ISSN: |
2052-4897 |
| DOI: |
10.1136/bmjdrc-2020-002026 |
| Popis: |
Introduction Diabetes 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 methods Prospective 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.Results Overall, 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.Conclusions Undiagnosed 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: |
Directory of Open Access Journals |
| Externí odkaz: |
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