Many people who developed diabetes during a hospitalization for COVID-19 experienced a return to lower blood glucose levels after their time in the hospital, according to a new study published in the Journal of Diabetes and its Complications.
New cases of diabetes have been one of the most perplexing aspects of severe COVID-19 throughout the pandemic. While many people with preexisting diabetes who were hospitalized for the viral infection experienced major blood glucose disruptions — often requiring large amounts of insulin to control their blood glucose levels — doctors also saw cases in which people with no documented history of diabetes were suddenly in need of intensive blood glucose management. Some researchers speculated that the viral infection could have damaged the function of the pancreas, while at the same time the stress of the infection could have led to problems with glucose metabolism throughout the body. But until now, there haven’t been any major studies looking at how long these effects might last in people who are diagnosed with diabetes during a hospitalization for COVID-19.
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To study the lasting effects of COVID-19 hospitalization on blood glucose levels, researchers at Massachusetts General Hospital (MGH) in Boston compared outcomes in people who developed diabetes during their hospitalization and in those who already had diabetes when they were admitted. They looked at hospitalizations that took place between March and September 2020, with follow-up lasting until July 2021. Out of 1,902 people hospitalized for COVID-19 during the study period, 594 had diabetes, representing 31% of all patients. Out of those hospitalized people with diabetes, 13% had what appeared to be new-onset diabetes. Compared with patients who had preexisting diabetes, those with new-onset diabetes were more likely to be younger and less likely to identify as non-Hispanic white. In cases of new-onset diabetes, blood glucose levels tended to be lower than in cases of preexisting ideates, but inflammatory markers were higher in these patients during their hospitalization for COVID-19.
Some cases of new-onset diabetes after COVID-19 found to resolve
After adjusting for as many demographic differences as possible between hospitalized patients with preexisting or new-onset diabetes — such as age and race or ethnicity — the researchers found that compared with preexisting diabetes, new-onset diabetes was linked to lower in-hospital insulin requirements, a longer hospital stay, and greater risk of admission to the intensive care unit (ICU), but not a greater risk of death. In a group of 64 study participants with new-onset diabetes who were discharged form the hospital, the researchers found that during a median follow-up period of 323 days, 36 (56%) continued to have diabetes, while 26 (41%) experienced a return to normal blood glucose levels or prediabetes. Another two participants couldn’t have their diabetes status classified.
“We believe that the inflammatory stress caused by COVID-19 may be a leading contributor to ‘new-onset’ or newly diagnosed diabetes,” said study author Sara Cromer, MD, an investigator in the Department of Medicine at MGH, in a press release on the study. “These patients may only need insulin or other medications for a short time, and it’s therefore critical that physicians closely follow them to see if and when their conditions improve.”
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