Predictors of Poor Glycemic Control and Increased Glucose Variability Among Admitted Moderate to Critical COVID-19 Patients with Type 2 Diabetes Mellitus: A Single Center Cross-Sectional Study

John Paul Martin Bagos; Erick Mendoza; Bien Matawaran

doi:10.15605/jafes.038.02.07

Authors

John Paul Martin Bagos University of Santo Tomas Hospital, Manila, Philippines https://orcid.org/0000-0002-8665-8377
Erick Mendoza University of Santo Tomas Hospital, Manila, Philippines
Bien Matawaran University of Santo Tomas Hospital, Manila, Philippines

DOI:

https://doi.org/10.15605/jafes.038.02.07

Keywords:

COVID-19, type 2 Diabetes, hyperglycemia, risk factors

Abstract

Objectives. COVID-19 exacerbates the long-standing, low-grade chronic inflammation observed in diabetes leading to heightened insulin resistance and hyperglycemia. Mortality increases with hyperglycemia and poor glycemic variability, hence, this study aims to identify the predictors associated with poor glycemic control and increased glucose variability among patients with COVID-19 and Type 2 Diabetes Mellitus (T2DM).

Methodology. A retrospective chart review of 109 patients with moderate to severe COVID-19 and T2DM admitted from March 2020 to June 2021 was done. Logistic regression was done to determine predictors for hyperglycemia and poor variability.

Results. Of the 109 patients, 78% had hyperglycemia and poor variability and 22% had no poor outcomes. Chronic kidney disease (eOR 2.83, CI [1.07-7.46], p=0.035) was associated with increased glycemic variability. In contrast, increasing eGFR level (eOR 0.97, CI [0.96-0.99], p=0.004) was associated with less likelihood of increased variability. Hs-CRP (eOR 1.01, CI [1.00-1.01], p=0.011), HbA1c (eOR 1.86, CI [1.23-2.82], p=0.003), severe COVID-19 (eOR 8.91, CI [1.77-44.94], p=0.008) and critical COVID-19 (eOR 4.42, CI [1.65-11.75], p=0.003) were associated with hyperglycemia. Steroid use (eOR 71.17, CI [8.53-593.54], p<0.001) showed the strongest association with hyperglycemia.

Conclusion. Potential clinical, laboratory and inflammatory profiles were identified as predictors for poor glycemic control and variability outcomes. HbA1c, hs-CRP, and COVID-19 severity are predictors of hyperglycemia. Likewise, chronic kidney disease is a predictor of increased glycemic variability.

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Author Biographies

John Paul Martin Bagos, University of Santo Tomas Hospital, Manila, Philippines

Department of Medicine, Section of Endocrinology, Diabetes and Metabolism

Erick Mendoza, University of Santo Tomas Hospital, Manila, Philippines

Consultant, Department of Medicine, Section of Endocrinology, Diabetes and Metabolism

Bien Matawaran, University of Santo Tomas Hospital, Manila, Philippines

Consultant, Department of Medicine, Section of Endocrinology, Diabetes and Metabolism

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