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Glucose control in the early phase of hospitalization is associated with severe prognosis in coronavirus disease 2019 (COVID-19) patients with diabetes in Japan

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Abstract

We investigated the association of glycemic control in the early phase of hospitalization with the prognosis of COVID-19 in patients with diabetes. We analyzed the relationship between various clinical indices, including preprandial blood glucose levels measured by self-monitoring devices in the early phase after admission, and severe prognosis in 189 patients with complicated diabetes who were admitted to our hospital between February 22, 2020 and June 20, 2021. Enrolled patients had a median age of 72 years, median body mass index of 24.7, median HbA1c of 7.1%, and median mean preprandial capillary glucose (PPCG) of 179.1 mg/dL. Sixty-six patients progressed to severe disease, and the mean PPCG in severe cases was significantly higher than that in non-severe cases, 195.2 vs 167.8 mg/dL (p = 0.005). Analysis of the receiver operating characteristic curve showed that 179 mg/dL was the cut-off value, and the risk of severity was significantly higher in patients with a mean PPCG of 180 mg/dL or higher (odds ratio (OR) 3.210, p = 0.017) in multiple regression analysis. In this study, we found that the risk of severe COVID-19 increased in patients with a high mean PPCG in the early phase of hospitalization, suggesting that good glucose control in the early phase of COVID-19 with diabetes may be effective in preventing disease severity.

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The datasets in the manuscript are available from the corresponding author on reasonable request.

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Acknowledgements

We thank the medical staff and physicians at Toyonaka Municipal Hospital. Dr. Satoko Yamamoto developed a clinical pathway for COVID-19 treatment. Kazumi Ohkubo and Misuzu Touyama managed nursing care in the infection units, and Norihiro Suzuki and Nozomi Akase managed infection control in the hospital. We would like to thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Diabetes Center, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan

    Yukiyoshi Okauchi, Ryuki Sakamoto, Tomoko Kaketaka, Eri Yamabayashi, Motohiro Kubori, Shinya Inada & Hiromi Iwahashi

  2. Department of Internal Medicine, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan

    Yukiyoshi Okauchi, Ryuki Sakamoto, Tomoko Kaketaka, Eri Yamabayashi, Motohiro Kubori, Shinya Inada, Osamu Morimura, Yasushi Otani, Kinya Abe & Hiromi Iwahashi

  3. Department of Gastroenterology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan

    Tsutomu Nishida

Authors
  1. Yukiyoshi Okauchi
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  2. Ryuki Sakamoto
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  3. Tomoko Kaketaka
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  8. Yasushi Otani
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  9. Kinya Abe
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  10. Tsutomu Nishida
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  11. Hiromi Iwahashi
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Contributions

YO and RS contributed equally to this study. YO and RS designed the study, analyzed the data, and wrote the manuscript. TK and HI analyzed the data and wrote the manuscript. EY, MK, SI, OM, YO, KA, and TN collected data and reviewed the manuscript. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Yukiyoshi Okauchi.

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Conflicts of interest

None of the authors have any potential conflicts of interest to declare associated with this research.

Ethical approval

This study was approved by the Ethics Committees of Toyonaka Municipal Hospital (No. 2020-05-12, approval date: July 17, 2020). All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and/or with the Helsinki Declaration of 1964 and later versions.

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The requirement for informed consent was waived using the opt-out method on our hospital website.

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Cite this article

Okauchi, Y., Sakamoto, R., Kaketaka, T. et al. Glucose control in the early phase of hospitalization is associated with severe prognosis in coronavirus disease 2019 (COVID-19) patients with diabetes in Japan. Diabetol Int 14, 406–412 (2023). https://doi.org/10.1007/s13340-023-00656-8

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  • DOI: https://doi.org/10.1007/s13340-023-00656-8

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