Are COVID19 patients with unknown diabetes at higher risk?

As the world continues to battle the COVID 19 pandemic concerns are being raised about a bi‐directional relationship with diabetes. Yingting Cao has been collaborating with colleagues from McMaster University, Coventry University, Monash University, Christian Medical College, Vellore Tamil Nadu, India  to conduct a series of studies including commentaries and systematic reviews into the relationships between COVID and patients with unknown pre-existing diabetes.

The team propose that pre-existing diabetes or pre-diabetes without diagnosis might increase the severity of the COVID infection. COVID patients with diagnosed pre-existing diabetes are at higher risk of poor outcome, including severe illness and increased mortality comparing those without diabetes before admission of COVID. However, patients diagnosed with diabetes at admission of COVID, tend to have increased levels of inflammatory markers and indicators of multi-organ injury and are more likely to experience severe or critical illness of COVID-19.

Blue Virus with spikesDr Cao’s review of recent studies found patients with undiagnosed diabetes are more susceptible to developing acute hyperglycemic crisis as they have no established routine to monitor for glucose because their condition has been unknown. Hospital clinicians need to be more alert to newly diagnosed diabetes at COVID admission by screening all COVID patients with blood glucose and glycosylated hemoglobin and monitor them closely for in-hospital complications.

Patients with unknow diabetes on COVID-19 admission are a high‐risk group. Dr Tina Cao

The study concludes these patients with unknow diabetes on COVID-19 admission are a high‐risk group and should be closely monitored for the emergence of cardiometabolic disorders in the long term. As long-term care will be required after discharge, GPs and other diabetes management professionals will need to be notified to provide a long-term treatment and monitor plan.

Read Yingting’s recent publications

  1. What is the role of admission HbA1c in managing COVID‐19 patients?
  2. Proportion of newly diagnosed diabetes in COVID‐19 patients: A systematic review and meta‐analysis 
  3. Preexisting prediabetes and the severity of COVID-19 
  4. Newly diagnosed diabetes in COVID-19 patients
  5. Is newly diagnosed diabetes a stronger risk factor than pre‐existing diabetes for COVID‐19 severity?
  6. Is newly diagnosed diabetes as frequent as preexisting diabetes in COVID-19 patients?

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Dr Tina Cao