New special section in ADA’s Diabetes Care® journal covers breaking research on diabetes care and treatment during COVID-19 pandemic
Medical experts from around the globe are sharing the most current findings surrounding COVID-19 and its impact on people with diabetes. In a special Diabetes and COVID-19 section available online today in Diabetes Care, a peer-reviewed journal of the American Diabetes Association® (ADA), studies and analyses of hospitalized COVID-19 patients are presented, along with commentary recommendations on cardiovascular disease risk-management, continuous glucose management, gestational diabetes testing during the pandemic, and future research funding and needs.
In the section’s introductory commentary, “COVID-19 in People With Diabetes: Urgently Needed Lessons From Early Reports,” Editor-in-Chief Matthew Riddle, MD, of Oregon Health & Science University outlines the history of the pandemic and offers an informative overview of the entire section. In so doing, Dr. Riddle highlights the importance of learning more about the risks COVID-19 poses to people living with diabetes. “The consistency of findings in these rapidly published reports is reassuring in terms of scientific validity, but the story unfolding is worrisome,” states Dr. Riddle. “Diabetes has not yet been shown to increase the likelihood of infection, but progression to severe illness is more likely in people with diabetes. Neither the mechanisms underlying the increased risk nor the best interventions to limit it have yet been defined, but the studies in this issue offer important clues.”
Additional commentaries offer expert assessments of important challenges and opportunities for patient care and research. Specific studies surrounding COVID-19 and obesity, diabetes medications, mortality, and safely managing hospitalized patients’ blood glucose levels are available online today, with the entire special section appearing in the July issue of Diabetes Care. The following research articles are available immediately:
Clinical characteristics and outcomes of patients with diabetes and COVID-19 in association with glucose-lowering medication
In this study, researchers analyzed data of 904 COVID-19 patients, of whom 136 had diabetes, to evaluate whether the type of prior glucose-lowering therapies used by those with diabetes was associated with outcomes. Results showed mortality rates in the patients with diabetes were two to three times higher than in those without diabetes, and within the diabetes subgroup, older age and higher C-reactive protein levels (a measurement that increases when there is inflammation in the body) were independent predictors of death. Further analyses suggested that the use of insulin was associated with worse outcomes; however, it was unclear if this was due to effects of insulin itself or to characteristics of the patients for whom it was prescribed.
Clinical characteristics and risk factors for mortality of COVID-19 patients with diabetes in Wuhan, China: A two-center, retrospective study
Researchers compared the characteristics and outcomes of 153 patients with diabetes with an equal number of patients without diabetes of the same age and sex. Both groups had similar duration of COVID-19 symptoms, but PaO2 (a measurement of how well oxygen moves from the lungs to the blood) was lower in the diabetes group upon admission. The death rate was higher in the patients with diabetes, with models suggesting older age and hypertension independently contributed to the higher mortality number.
Obesity and COVID-19 severity in a designated hospital in Shenzhen, China
This analysis studied 383 hospitalized patients and divided them into groups by weight according to BMI measurements. After adjusting for diabetes, hypertension, liver disease, and other clinical features, results indicated the patients in the obese group had increased odds of progression to severe illness compared to the patients in the normal-weight group.
Obesity is a risk factor for greater COVID-19 severity
Researchers in this study warn of the impact of obesity on the severity of COVID-19. When they compared 75 Chinese patients with COVID-19 who were obese to 75 Chinese patients with COVID-19 who were non-obese but within the same sex and age group, they determined obesity increases the risk of severe illness approximately threefold after adjustment for clinical characteristics including the presence of diabetes. Results showed a nearly linear relationship between higher BMI and severe/critical illness in all the patients.
Remote glucose monitoring of hospitalized, quarantined patients with diabetes and COVID-19
A team in a hospital in Israel successfully converted a continuous glucose-monitoring system from a personal tool to a team-based, real-time remote glucose-monitoring system utilized by intensive care unit staff. Their efforts, including staff training and visualization of several patients on one control screen, led to improvements in average glucose levels in the facility’s first COVID-19 patients with diabetes upon whom the system was used. The initiative was implemented to maintain the standard of care for patients with diabetes, which includes monitoring glucose levels regularly, while also striving to prevent patient-staff transmission of COVID-19.
Two additional research articles will be online and included in the special section in the coming days. One study offers further insight into glycemic control via insulin and its potential impact on COVID-19 patient outcomes. Another article evaluates the possible association between diabetes and the expression of a molecule that researchers think may be a site of attachment for the virus responsible for COVID-19 to explore if people with diabetes are more prone to COVID-19 infection.
For additional information on the studies in the special section, or any of the articles published in Diabetes Care, please contact the ADA media relations team at press@diabetes.org.
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,About Diabetes Care®
Diabetes Care, a monthly journal of the American Diabetes Association (ADA), is the highest-ranked, peer-reviewed journal in the field of diabetes treatment and prevention. Dedicated to increasing knowledge, stimulating research and promoting better health care for people with diabetes, the journal publishes original articles on human studies in clinical care, education and nutrition; epidemiology, health services and psychosocial research; emerging treatments and technologies; and pathophysiology and complications. Diabetes Care also publishes the ADA’s recommendations and statements, clinically relevant review articles, editorials and commentaries. Topics covered are of interest to clinically oriented physicians, researchers, epidemiologists, psychologists, diabetes educators and other health care professionals.
About the American Diabetes Association
Every day more than 4,000 people are newly diagnosed with diabetes in America. More than 122 million Americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. The American Diabetes Association (ADA) is the nation’s leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For nearly 80 years the ADA has been driving discovery and research to treat, manage and prevent diabetes, while working relentlessly for a cure. We help people with diabetes thrive by fighting for their rights and developing programs, advocacy and education designed to improve their quality of life. Diabetes has brought us together. What we do next will make us Connected for Life. To learn more or to get involved, visit us at diabetes.org or call 1-800-DIABETES (1-800-342-2383). Join the fight with us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).
