Endocrinology Unit, Haemek Medical Center, Afula, Israel.
Statistic Department, Haemek Medical Center, Afula, Israel.
Medicine (Baltimore). 2023 Jan 20;102(3):e32650. doi: 10.1097/MD.0000000000032650.
Coronavirus disease (COVID-19) is closely associated with hyperglycemia and a worse prognosis in patients with a previous diagnosis of type 2 diabetes mellitus. A few studies investigated the effects of diabetes treatment regimens in these patients during hospitalization. Here, we evaluate the impact of insulin and non-insulin therapy on glucose control in patients with type 2 diabetes admitted with COVID-19. This is a retrospective study including 359 COVID-19 patients with type 2 diabetes. Patients were divided into 2 groups according to diabetes treatment during hospitalization. The first group included patients treated with insulin only, and the second group patients treated with other antidiabetic agents with or without insulin. Average blood glucose was higher in the insulin-only treatment group (201 ± 66 mg/dL vs 180 ± 71 mg/dL, P = .004), even after excluding mechanically ventilated patients (192 ± 69 vs 169 ± 59 mg/dL, P = .003). In patients with moderate severity of COVID-19, average blood glucose was also significantly higher in the insulin-only treated group (197 ± 76 vs 168 ± 51 mg/dL, P = .001). Most patients (80%) in the combination treatment group received metformin. Moderately affected COVID-19 patients with type 2 diabetes could safely be treated with antihyperglycemic medications with or without insulin.
新型冠状病毒疾病（COVID-19）与先前诊断为 2 型糖尿病患者的高血糖和预后不良密切相关。一些研究调查了这些患者住院期间糖尿病治疗方案的影响。在这里，我们评估了胰岛素和非胰岛素治疗对 COVID-19 住院的 2 型糖尿病患者血糖控制的影响。这是一项回顾性研究，共纳入 359 名 COVID-19 合并 2 型糖尿病患者。根据住院期间的糖尿病治疗将患者分为两组。第一组包括仅接受胰岛素治疗的患者，第二组包括接受其他降糖药物治疗的患者，无论是否使用胰岛素。仅接受胰岛素治疗的组平均血糖较高（201±66mg/dL 与 180±71mg/dL，P=0.004），甚至排除机械通气患者后也是如此（192±69mg/dL 与 169±59mg/dL，P=0.003）。在 COVID-19 中度患者中，仅接受胰岛素治疗的组平均血糖也明显更高（197±76mg/dL 与 168±51mg/dL，P=0.001）。联合治疗组中的大多数患者（80%）接受了二甲双胍治疗。可以安全地使用胰岛素或不使用胰岛素的降糖药物治疗 COVID-19 中度影响的 2 型糖尿病患者。
