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在糖尿病患者中,门诊或住院血糖控制与 COVID-19 疾病严重程度或死亡率之间没有关联。

Lack of association between either outpatient or inpatient glycemic control and COVID-19 illness severity or mortality in patients with diabetes.

机构信息

Division of Endocrinology and Metabolism, Department of Medicine, University of California San Francisco, San Francisco, California, USA

Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.

出版信息

BMJ Open Diabetes Res Care. 2021 May;9(1). doi: 10.1136/bmjdrc-2021-002203.

Abstract

INTRODUCTION

To evaluate whether outpatient insulin treatment, hemoglobin A1c (HbA1c), glucose on admission, or glycemic control during hospitalization is associated with SARS-CoV-2 (COVID-19) illness severity or mortality in hospitalized patients with diabetes mellitus (DM) in a geographical region with low COVID-19 prevalence.

RESEARCH DESIGN AND METHODS

A single-center retrospective study of patients hospitalized with COVID-19 from January 1 through August 31, 2020 to evaluate whether outpatient insulin use, HbA1c, glucose on admission, or average glucose during admission was associated with intensive care unit (ICU) admission, mechanical ventilation (ventilator) requirement, or mortality.

RESULTS

Among 111 patients with DM, 48 (43.2%) were on outpatient insulin and the average HbA1c was 8.1% (65 mmol/mol). The average glucose on admission was 187.0±102.94 mg/dL and the average glucose during hospitalization was 173.4±39.8 mg/dL. Use of outpatient insulin, level of HbA1c, glucose on admission, or average glucose during hospitalization was not associated with ICU admission, ventilator requirement, or mortality among patients with COVID-19 and DM.

CONCLUSIONS

Our findings in a region with relatively low COVID-19 prevalence suggest that neither outpatient glycemic control, glucose on admission, or inpatient glycemic control is predictive of illness severity or mortality in patients with DM hospitalized with COVID-19.

摘要

简介

本研究旨在评估在 COVID-19 发病率较低的地区,门诊胰岛素治疗、糖化血红蛋白(HbA1c)、入院时血糖或住院期间血糖控制情况是否与住院糖尿病(DM)患者的 SARS-CoV-2(COVID-19)疾病严重程度或死亡率相关。

研究设计和方法

这是一项单中心回顾性研究,纳入了 2020 年 1 月 1 日至 8 月 31 日期间因 COVID-19 住院的患者,旨在评估门诊胰岛素使用、HbA1c、入院时血糖或住院期间平均血糖是否与入住重症监护病房(ICU)、机械通气(呼吸机)需求或死亡率相关。

结果

在 111 例 DM 患者中,48 例(43.2%)正在接受门诊胰岛素治疗,平均 HbA1c 为 8.1%(65mmol/mol)。入院时平均血糖为 187.0±102.94mg/dL,住院期间平均血糖为 173.4±39.8mg/dL。在 COVID-19 合并 DM 患者中,门诊胰岛素使用、HbA1c 水平、入院时血糖或住院期间平均血糖与入住 ICU、呼吸机需求或死亡率均无相关性。

结论

在 COVID-19 发病率相对较低的地区,我们的研究结果表明,门诊血糖控制、入院时血糖或住院期间血糖控制均不能预测 COVID-19 住院 DM 患者的疾病严重程度或死亡率。

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