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2019冠状病毒病住院期间首次检测到的糖尿病范围高血糖患者的长期结局:一项单中心观察性研究

Long-term outcome of patients with diabetic-range hyperglycemia first detected during admission for COVID-19: A single-center observational study.

作者信息

Agarwal Ketan, Kirti Ravi, Shyama Shyama, Kumar Pragya, Biswas Ratnadeep, Ojha Vishnu S

机构信息

Department of General Medicine, All India Institute of Medical Sciences Patna, Phulwari Sharif, Patna, Bihar, India.

Department of Community and Family Medicine, All India Institute of Medical Sciences Patna, Phulwari Sharif, Patna, Bihar, India.

出版信息

J Family Med Prim Care. 2024 Aug;13(8):3374-3380. doi: 10.4103/jfmpc.jfmpc_140_24. Epub 2024 Jul 26.

Abstract

BACKGROUND AND OBJECTIVE

Diabetic-range hyperglycemia has been reported for the first time in many patients during their hospitalization with coronavirus disease 2019 (COVID-19). This study was undertaken to determine the proportion of such patients who actually have new-onset diabetes mellitus rather than transient hyperglycemia during acute illness.

METHODS

This descriptive study included patients with diabetic-range hyperglycemia first detected at or during admission for COVID-19 but no prior history of diabetes. The study protocol involved patient identification, data recording from the case-notes, and telephonic follow-ups. Blood sugar levels done at least two weeks after discharge or the last dose of steroids, whichever was later, were recorded, and patients were categorized as diabetic, pre-diabetic, or non-diabetic accordingly.

RESULTS

Out of 86 patients, ten (11.6%) were found to have developed diabetes, and 13 (15.1%) had pre-diabetes on follow-up. About 63 (73.3%) patients had become normoglycemic. Eight (80%) out of the ten patients with new-onset diabetes were on treatment, with five (50%) achieving the target glycemic levels. The associations of new-onset diabetes with age, gender, comorbidities, intensive care stay, and steroid administration were not found to be statistically significant (-values 0.809, 0.435, 0.324, 0.402, and 0.289, respectively).

INTERPRETATION AND CONCLUSIONS

While a majority of post-COVID patients with diabetic-range hyperglycemia returned to a normoglycemic state after the acute illness had settled down, one in ten developed new-onset diabetes, and an additional one in seven had impaired glucose tolerance. Thus, regular glucose screening is crucial for such patients and lifestyle modifications should be encouraged to reduce the risk of diabetes. Loss to follow-up and reliance on a single set of blood sugar readings for classification were some of the limitations of this study.

摘要

背景与目的

首次有报道称,许多2019冠状病毒病(COVID-19)住院患者出现了糖尿病范围的高血糖。本研究旨在确定此类患者中在急性疾病期间实际患有新发糖尿病而非短暂性高血糖的比例。

方法

本描述性研究纳入了在COVID-19入院时或入院期间首次检测到糖尿病范围高血糖但既往无糖尿病史的患者。研究方案包括患者识别、病历数据记录以及电话随访。记录出院后至少两周或最后一剂类固醇用药后(以较晚者为准)的血糖水平,并据此将患者分类为糖尿病患者、糖尿病前期患者或非糖尿病患者。

结果

在86例患者中,随访发现10例(11.6%)患了糖尿病,13例(15.1%)有糖尿病前期。约63例(73.3%)患者血糖恢复正常。10例新发糖尿病患者中有8例(80%)正在接受治疗,其中5例(50%)达到了血糖目标水平。未发现新发糖尿病与年龄、性别、合并症、重症监护病房住院时间和类固醇用药之间的关联具有统计学意义(P值分别为0.809、0.435、0.324、0.402和0.289)。

解读与结论

虽然大多数COVID-19后出现糖尿病范围高血糖的患者在急性疾病缓解后恢复到血糖正常状态,但十分之一的患者出现了新发糖尿病,另外七分之一的患者糖耐量受损。因此,对此类患者进行定期血糖筛查至关重要,应鼓励改变生活方式以降低糖尿病风险。失访以及依靠单次血糖读数进行分类是本研究的一些局限性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05f5/11368375/c7ccbf308d69/JFMPC-13-3374-g001.jpg

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