Poor glycemic management – first 48 hours in hospital – leads to worse COVID outcomes (Even if you have good blood sugar management at home?)

I have to admit this hadn’t crossed my mind until it crossed my inbox this morning.

“Hi Riva, 

Glytec has just released brand new research published in Diabetes Care, which is the first study of its kind to study the ‘opportunity window’ for treating hospitalized patients with hyperglycemia or diabetes. Findings included:

  • A higher risk of mortality for patients that did not achieve target blood glucose levels soon after being admitted to the hospital.
  • 7x mortality risk for non-ICU patients with severe hyperglycemia after 48 to 72 hours, indicating the need to start treatment of hyperglycemia on admission.

Glytec is offering a webinar Tuesday, February 2nd at 1 PM EDT with those who co-authored the research if you want to learn more. You can register here.

Yes, I did know that people with diabetes who have poor blood sugar management are 2-4x more likely to have worse outcomes if they get COVID-19.

Yet, I had thought I would fall into the other camp, the studies that show people with diabetes, who have good blood sugar management, are no more at risk of getting COVID than those who don’t have diabetes.

Like the Jewish holiday, Passover, COVID would just pass over me and chose someone else. It never crossed my mind that should I get COVID, and end up in the hospital, the poor care I might receive there (few hospitalists know how to manage blood sugar) would be my undoing; my good blood sugar management unraveling quickly under another’s uneducated care.

I often remind the husband should I be in the hospital (this was pre-COVID) you must be my advocate. You must make sure they let me manage my blood sugar provided my brain cells are working. Now I realize how important heeding that directive is.

Addendum: I checked in with my diabetologist expert in Israel, Professor Itamar Raz, about this who said this information is not yet evidence-based and is controversial. And I checked in with my diabetes expert in the UK, Professor Philip Home, who says roughly that if you have had good management of your blood sugar for some time, and no major complications, before contracting COVID you would tend to deteriorate less quickly and you will be less at risk for worse outcomes. So let’s all take a breath.

That said, experts advise you have a letter from your doctor with you at all times that states your health condition(s), medications and that if you are able and prefer, you should continue to manage your blood sugar if in the hospital. For a look at my letter click here.

2 thoughts on “Poor glycemic management – first 48 hours in hospital – leads to worse COVID outcomes (Even if you have good blood sugar management at home?)

  1. Good post. Interesting, wide ranging article in new Consumer Reports about diabetes. It includes an explanation of why COVID may be so much more “problematic” for those with diabetes. Steroids used to fight COVID, higher blood sugar, risk of DKA all contribute to a hurricane.

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