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ORIGINAL ARTICLES
Year : 2021  |  Volume : 12  |  Issue : 1  |  Page : 22-27

Impact of glycemic control in diabetes mellitus on management of COVID-19 infection


1 Department of General Medicine, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
2 Department of Physiology and Ethical Committee, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India

Correspondence Address:
Dr. Govind Rankawat
Department of General Medicine, SMS Medical College and Attached Group of Hospitals, J.L.N. Marg, Jaipur 302004, Rajasthan, India.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jod.jod_58_20

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Background: This study was undertaken to evaluate the clinical presentation, laboratory parameters, radiological imaging, management, and outcome of coronavirus disease-2019 (COVID-19) infection in patients of diabetes mellitus and its association with glycemic control. Materials and Methods: This study conducted on 80 admitted COVID-19 patients of known diabetes mellitus, who were categorized into two groups: Group 1 had patients with uncontrolled diabetes as indicated by hemoglobin A1c (HbA1c) > 8 gm% and Group 2 had patients with controlled diabetes as indicated by HbA1c < 8 gm%. Information concerning medical history, clinical manifestations, laboratory findings, radiological imaging, management, and outcome was extracted from medical records for evaluation, interpretation, and association among both the groups. Results: COVID-19 patients with uncontrolled diabetes showed a severe symptomatic presentation, excessive uncontrolled inflammatory responses, and hypercoagulable state. Total leukocyte count, neutrophil–lymphocyte ratio, serum levels of interleukin-6 (IL-6), fibrin degradation product (FDP), and D-dimer were significantly raised (P < 0.05) in case of uncontrolled diabetes as compared to controlled diabetes. Radiological findings detected by chest radiograph and computed tomography chest suggested severe lung involvement in uncontrolled diabetes. COVID-19 patients with uncontrolled diabetes required intensive treatment as compared to controlled diabetes group in terms of insulin therapy (P = 0.0226) and noninvasive ventilation (P = 0.0292). Patients with uncontrolled diabetes had higher mortality (P = 0.0375) and required prolonged hospitalization (P = 0.0479) as compared to controlled diabetes group. Conclusion: From this study, it can be concluded that uncontrolled diabetes mellitus might be responsible for an overall higher susceptibility for COVID-19 infection and severity in terms of symptomatic presentation, inflammatory storm, rapid pulmonary invasion, requirement of more intensive treatment and a poor outcome.


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