As the ongoing coronavirus pandemic grapples the whole world, researchers have been digging deeper into how the infection wreaks havoc in the body, especially for the ones with pre-existing medical conditions, such as diabetes, obesity, and hypertension.
Now, a new study conducted on 200 COVID-19 patients with severe hyperglycemia (high blood sugar) has shed light on how diabetes may trigger worse outcomes in people infected by the coronavirus.
A Michigan Medicine team developed a blood sugar management tool that could potentially help reduce the risk of secondary infections, kidney issues, ICU stays in people with diabetes, prediabetes, or obesity who are infected by COVID-19.
Dr. Roma Gianchandani, a professor in the Michigan Medicine Division of Metabolism, Endocrinology and Diabetes, said, “Based on preliminary observations of our patients, those with one of these pre-existing conditions are at high risk for making the virus-induced respiratory dysfunction much worse, potentially resulting in death.”
Senior author of the study Dr. Rodica Pop-Busui explained that hyperglycemia might trigger worse outcomes in COVID-19 patients due to low grade, inflammatory nature of diabetes, or high blood sugar that promotes the inflammatory surge of the virus, resulting in insulin resistance and severe hyperglycemia.
“When the body becomes this inflamed, it triggers an abnormal immune response that instead of just attacking the virus, affects the rest of the body’s healthy cells and tissue, leading to rapid deterioration in health,” she said.
In particular, COVID-19 patients with hyperglycemia are at an increased risk for ventilation, kidney replacement therapy due to kidney failure, and requiring vasopressors to stop potentially dangerously low blood pressure.
“All of these complications make blood sugar management more difficult, but our team is convinced this management is essential to prevent complications that lead to prolonged inpatient stays, or morbidity,” Dr. Gianchandani said. “A recent study has already shown there’s a correlation between well-controlled blood sugar and lower levels of inflammatory markers.”
The team developed a tool to identify, monitor, and manage high blood sugar in COVID-19 patients, which can help place them into certain categories keeping their risk factors into consideration.
The new tool helps diabetics to check their blood sugars without having to use PPE to visit the doctor’s office all the time, reducing their as well as their provider’s exposure to the virus.
Dr. Gianchandani explained, “Improving blood sugar control was important in reducing the amount of secondary infections and kidney issues this cohort of patients are susceptible to. This might help shorten ICU stays and lessen the amount of patients that need a ventilator.”
The new tool has been developed based on preliminary observation in the patients who were assessed by the research team. Therefore, they said a larger, controlled study is required to understand how the tool could impact mortality, recovery time, the duration of ICU stays, and the rate of severe complications. Dr. Gianchandani added, “Our team is looking forward to the next steps in confirming our hypothesis. In the meantime, I think these observations validate the importance of blood sugar management in COVID-19 patients and can serve as a guide or inspiration for other institutions.”
