J Diabetes Investig . Association of acute-to-chronic glycemic ratio and outcomes in patients with COVID-19 and undiagnosed diabetes mellitus: A retrospective nationwide cohort study

[tetano]

J Diabetes Investig


. 2023 Jan 27.
doi: 10.1111/jdi.13979. Online ahead of print.
Association of acute-to-chronic glycemic ratio and outcomes in patients with COVID-19 and undiagnosed diabetes mellitus: A retrospective nationwide cohort study


Masaki Uchihara ¹ , Takehiro Sugiyama ^{2 3 4} , Ryotaro Bouchi ^{1 2} , Nobuaki Matsunaga ⁵ , Yusuke Asai ⁵ , Hiroyuki Gatanaga ⁶ , Mitsuru Ohsugi ^{1 2} , Norio Ohmagari ^{6 7} , Hiroshi Kajio ¹ , Kohjiro Ueki ^{1 8}



Affiliations

• PMID: 36708095
• DOI: 10.1111/jdi.13979

Free article

Abstract

Aims/introduction: To assess the association of undiagnosed diabetes mellitus and its acute-to-chronic glycemic ratio with clinical outcome in patients hospitalized with coronavirus disease 2019 (COVID-19) using a large-scale nationwide registry in Japan.
Materials and methods: Overall, 4,747 patients were included between July 2021 and January 2022. We evaluated blood glucose and glycated hemoglobin levels at admission, and calculated the acute-to-chronic glycemic ratio for each non-diabetes mellitus, undiagnosed diabetes mellitus and pre-existing diabetes mellitus group. The primary composite outcome comprised in-hospital mortality, invasive mechanical ventilation, extracorporeal membrane oxygenation support, intensive care unit admission and transfer to a more advanced medical facility.
Results: Compared with the non-diabetes mellitus group, the undiagnosed diabetes mellitus group was significantly associated with a worse COVID-19 outcome (odds ratio 2.18, 95% confidence interval 1.50-3.18). In patients with undiagnosed diabetes mellitus, the 3rd tertile of the acute-to-chronic glycemic ratio was linked with a worse COVID-19 outcome compared with the 1st tertile (odds ratio 3.33, 95% confidence interval 1.43-7.77), whereas glycated hemoglobin levels were not; among patients with pre-existing diabetes mellitus, glycated hemoglobin levels were linked with a worse outcome.
Conclusions: Among patients with undiagnosed diabetes mellitus with COVID-19, the magnitude of elevation of blood glucose from chronic to acute levels is associated with worse outcomes.

Keywords: Acute-to-chronic glycemic ratio; COVID-19; Undiagnosed diabetes mellitus.