By Ernie Mundell and Robert Preidt
THURSDAY, February 18, 2021 (HealthDay News) – Diabetes is a huge risk factor for a major attack of COVID-19, and a new European study confirms it: It finds that 1 in 5 hospitalized COVID-19 patients with diabetes dies within 28 days of admission.
A US expert was not surprised by this gloomy finding.
“Diabetics are clearly in a very high risk category and should be among the first to receive the vaccine,” advised Dr. Mangala Narasimhan, who leads intensive care at Northwell Health in New Hyde Park, NY. She also advises people with diabetes to make sure they are in control of their blood sugar levels and avoid complications from the disease.
Such steps “really seem to make a difference in terms of survival after COVID infection,” said Narasimhan, who was not involved in the new study.
The research was led by Bertrand Cariou and Samy Hadjadj, diabetologists at Nantes University Hospital in France. In May last year, they released preliminary results showing that 10% of COVID-19 patients with diabetes died within seven days of hospitalization.
The more recent, updated results come from a larger number of patients – nearly 2,800 – who have been treated for COVID-19 in 68 hospitals across France. Their median age was 70, nearly two-thirds were men, and many were overweight. About 40% also had various forms of complications due to their diabetes.
During the 28 days after they were hospitalized, 21% of patients died, the French team reported in Diabetologia magazine on February 17.
Of the patients who survived at least a month, 50% were discharged from the hospital with a mean stay of nine days; 12% were still in the hospital on day 28 and 17% had been moved from their first hospital to another facility.
Younger age, routine diabetes therapy with the drug metformin, and longer symptoms prior to hospitalization were key factors in increased chances of being discharged from the hospital, the researchers said.
Patients who took insulin regularly – which may indicate more advanced diabetes – had a 44% higher risk of death than patients who did not take insulin, the researchers said. Long-term glycemic control was not associated with patient outcomes, but higher blood sugar levels at the time of hospitalization were a strong predictor of death and a lower likelihood of discharge.
Dr. Barbara Keber directs family medicine at Glen Cove Hospital in Glen Cove, NY. On reading the results, she said that “Diabetes is clearly a significant risk factor for both hospital intensive care / ventilation and death”. within one month of admission.
Keber said it “makes sense” for people with complications from poorly controlled diabetes to be at higher risk, as this creates a “pro-inflammatory condition” similar to that of advanced COVID-19.
However, Keber also warned that the death rate among COVID-19 patients, including those with diabetes, may have improved over the past year.
“This study was conducted in the first wave of the pandemic and many of the current treatment regimens and drugs tried in the early stages have not proven beneficial and other treatment regimens have taken their place,” she noted.
For example, “the current use of steroids for treatment may have a role in the [improved] Overall prognosis for patients and particularly for those with diabetes, “said Keber.
The American Diabetes Association has more about COVID-19.
SOURCES: Mangala Narasimhan, DO, Director, Critical Care, Northwell Health, New Hyde Park, NY; Barbara Keber, MD, Chair, Family Medicine, Glen Cove Hospital, Glen Cove, NY; Diabetologia, press release February 17, 2021
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