Jordi Ramon1, Gemma Llauradó1,2,3,4, Roberto Güerri2,3,5, Elisenda Climent1,2,3, Silvia Ballesta1,2, David Benaiges1,2,3, Inmaculada López-Montesinos2,5, Humberto Navarro1,3, Natalia Fernández1, Maria José Carrera1,3, Dídac Mauricio4,6,7, Juana A Flores-Le Roux1,2,3, Juan-José Chillarón1,2,3. 1. 1Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain. 2. 2Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain. 3. 3Departament de Medicina, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain. 4. 4CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain. 5. 5Department of Infectious Diseases, Hospital del Mar, Barcelona, Spain. 6. 6Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 7. 7Department of Medicine, Faculty of Medicine, University of Vic - Central University of Barcelona, Vic, Spain.
Abstract
OBJECTIVE: To evaluate the association between acute-to-chronic (A/C) glycemic ratio and mortality and severity outcomes for patients with type 2 diabetes (T2D) hospitalized with coronavirus disease 2019 (COVID-19). RESEARCH DESIGN AND METHODS: A total of 91 patients were included. We measured glycemia at admission and estimated the average chronic glucose levels to calculate the A/C glycemic ratio. The primary outcome was a composite of in-hospital mortality, intensive care unit admission, and mechanical ventilation. RESULTS: Thirty-five patients had a primary outcome event, presenting a significant association with the A/C glycemic ratio (hazard ratio [HR] 1.57 [95% CI 1.14-2.15], P = 0.005). In comparisons with the 2nd tertile, the 3rd tertile of the A/C glycemic ratio was associated with the primary outcome (HR 3.39 [95% CI 1.31-8.75], P = 0.012). In the multivariate analysis, after additional adjustment for age, sex, comorbidities, inflammatory markers, and corticosteroid therapy, the association for the 3rd tertile (HR 3.96 [95% CI 1.35-11.59], P = 0.012) remained significant. CONCLUSIONS: In patients with T2D hospitalized with COVID-19, the imbalance between acute glycemia at admission and chronic metabolic control is associated with worse prognosis.
OBJECTIVE: To evaluate the association between acute-to-chronic (A/C) glycemic ratio and mortality and severity outcomes for patients with type 2 diabetes (T2D) hospitalized with coronavirus disease 2019 (COVID-19). RESEARCH DESIGN AND METHODS: A total of 91 patients were included. We measured glycemia at admission and estimated the average chronic glucose levels to calculate the A/C glycemic ratio. The primary outcome was a composite of in-hospital mortality, intensive care unit admission, and mechanical ventilation. RESULTS: Thirty-five patients had a primary outcome event, presenting a significant association with the A/C glycemic ratio (hazard ratio [HR] 1.57 [95% CI 1.14-2.15], P = 0.005). In comparisons with the 2nd tertile, the 3rd tertile of the A/C glycemic ratio was associated with the primary outcome (HR 3.39 [95% CI 1.31-8.75], P = 0.012). In the multivariate analysis, after additional adjustment for age, sex, comorbidities, inflammatory markers, and corticosteroid therapy, the association for the 3rd tertile (HR 3.96 [95% CI 1.35-11.59], P = 0.012) remained significant. CONCLUSIONS: In patients with T2D hospitalized with COVID-19, the imbalance between acute glycemia at admission and chronic metabolic control is associated with worse prognosis.
Authors: Clara L Clausen; Christian Leo-Hansen; Daniel Faurholt-Jepsen; Rikke Krogh-Madsen; Christian Ritz; Ole Kirk; Henrik L Jørgensen; Thomas Benfield; Thomas P Almdal; Ole Snorgaard Journal: Diabetes Res Clin Pract Date: 2022-04-25 Impact factor: 8.180