John Paul Martin Bagos, Mendoza Erick, Bien Matawaran
{"title":"入院的中重度COVID-19合并2型糖尿病患者血糖控制不良和血糖变异性升高的预测因素:一项单中心横断面研究","authors":"John Paul Martin Bagos, Mendoza Erick, Bien Matawaran","doi":"10.15605/jafes.038.02.07","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>COVID-19 exacerbates the long-standing, low-grade chronic inflammation observed in diabetes leading to heightened insulin resistance and hyperglycemia. Mortality increases with hyperglycemia and poor glycemic variability, hence, this study aims to identify the predictors associated with poor glycemic control and increased glucose variability among patients with COVID-19 and Type 2 Diabetes Mellitus (T2DM).</p><p><strong>Methodology: </strong>A retrospective chart review of 109 patients with moderate to severe COVID-19 and T2DM admitted from March 2020 to June 2021 was done. Logistic regression was done to determine predictors for hyperglycemia and poor variability.</p><p><strong>Results: </strong>Of the 109 patients, 78% had hyperglycemia and poor variability and 22% had no poor outcomes. Chronic kidney disease (eOR 2.83, CI [1.07-7.46], <i>p</i> = 0.035) was associated with increased glycemic variability. In contrast, increasing eGFR level (eOR 0.97, CI [0.96-0.99], <i>p</i> = 0.004) was associated with less likelihood of increased variability. Hs-CRP (eOR 1.01, CI [1.00-1.01], <i>p</i> = 0.011), HbA1c (eOR 1.86, CI [1.23-2.82], <i>p</i> = 0.003), severe COVID-19 (eOR 8.91, CI [1.77-44.94], <i>p</i> = 0.008) and critical COVID-19 (eOR 4.42, CI [1.65-11.75], <i>p</i> = 0.003) were associated with hyperglycemia. Steroid use (eOR 71.17, CI [8.53-593.54], <i>p</i><0.001) showed the strongest association with hyperglycemia.</p><p><strong>Conclusion: </strong>Potential clinical, laboratory and inflammatory profiles were identified as predictors for poor glycemic control and variability outcomes. HbA1c, hs-CRP, and COVID-19 severity are predictors of hyperglycemia. Likewise, chronic kidney disease is a predictor of increased glycemic variability.</p>","PeriodicalId":41792,"journal":{"name":"Journal of the ASEAN Federation of Endocrine Societies","volume":"38 2","pages":"57-64"},"PeriodicalIF":0.6000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692407/pdf/","citationCount":"0","resultStr":"{\"title\":\"Predictors of Poor Glycemic Control and Increased Glucose Variability Among Admitted Moderate to Critical COVID-19 Patients with Type 2 Diabetes Mellitus: A Single Center Cross-sectional Study.\",\"authors\":\"John Paul Martin Bagos, Mendoza Erick, Bien Matawaran\",\"doi\":\"10.15605/jafes.038.02.07\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>COVID-19 exacerbates the long-standing, low-grade chronic inflammation observed in diabetes leading to heightened insulin resistance and hyperglycemia. Mortality increases with hyperglycemia and poor glycemic variability, hence, this study aims to identify the predictors associated with poor glycemic control and increased glucose variability among patients with COVID-19 and Type 2 Diabetes Mellitus (T2DM).</p><p><strong>Methodology: </strong>A retrospective chart review of 109 patients with moderate to severe COVID-19 and T2DM admitted from March 2020 to June 2021 was done. Logistic regression was done to determine predictors for hyperglycemia and poor variability.</p><p><strong>Results: </strong>Of the 109 patients, 78% had hyperglycemia and poor variability and 22% had no poor outcomes. Chronic kidney disease (eOR 2.83, CI [1.07-7.46], <i>p</i> = 0.035) was associated with increased glycemic variability. In contrast, increasing eGFR level (eOR 0.97, CI [0.96-0.99], <i>p</i> = 0.004) was associated with less likelihood of increased variability. Hs-CRP (eOR 1.01, CI [1.00-1.01], <i>p</i> = 0.011), HbA1c (eOR 1.86, CI [1.23-2.82], <i>p</i> = 0.003), severe COVID-19 (eOR 8.91, CI [1.77-44.94], <i>p</i> = 0.008) and critical COVID-19 (eOR 4.42, CI [1.65-11.75], <i>p</i> = 0.003) were associated with hyperglycemia. Steroid use (eOR 71.17, CI [8.53-593.54], <i>p</i><0.001) showed the strongest association with hyperglycemia.</p><p><strong>Conclusion: </strong>Potential clinical, laboratory and inflammatory profiles were identified as predictors for poor glycemic control and variability outcomes. HbA1c, hs-CRP, and COVID-19 severity are predictors of hyperglycemia. 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引用次数: 0
摘要
目的:COVID-19加剧了糖尿病患者长期存在的低度慢性炎症,导致胰岛素抵抗和高血糖加剧。死亡率随着高血糖和血糖变异性差而增加,因此,本研究旨在确定与COVID-19和2型糖尿病(T2DM)患者血糖控制差和血糖变异性增加相关的预测因素。方法:对2020年3月至2021年6月住院的109例中重度COVID-19合并T2DM患者进行回顾性图表分析。进行逻辑回归以确定高血糖和变异性差的预测因子。结果:109例患者中,78%有高血糖且变异性差,22%无不良预后。慢性肾病(eOR 2.83, CI [1.07-7.46], p = 0.035)与血糖变异性升高相关。相反,eGFR水平升高(eOR 0.97, CI [0.96-0.99], p = 0.004)与变异性增加的可能性降低相关。Hs-CRP (eOR 1.01, CI [1.00-1.01], p = 0.011)、HbA1c (eOR 1.86, CI [1.23-2.82], p = 0.003)、重症COVID-19 (eOR 8.91, CI [1.77-44.94], p = 0.008)、重症COVID-19 (eOR 4.42, CI [1.65-11.75], p = 0.003)与高血糖相关。结论:潜在的临床、实验室和炎症特征被确定为血糖控制不良和变异性结局的预测因素。HbA1c、hs-CRP和COVID-19严重程度是高血糖的预测指标。同样,慢性肾脏疾病是血糖变异性增加的一个预测指标。
Predictors of Poor Glycemic Control and Increased Glucose Variability Among Admitted Moderate to Critical COVID-19 Patients with Type 2 Diabetes Mellitus: A Single Center Cross-sectional Study.
Objectives: COVID-19 exacerbates the long-standing, low-grade chronic inflammation observed in diabetes leading to heightened insulin resistance and hyperglycemia. Mortality increases with hyperglycemia and poor glycemic variability, hence, this study aims to identify the predictors associated with poor glycemic control and increased glucose variability among patients with COVID-19 and Type 2 Diabetes Mellitus (T2DM).
Methodology: A retrospective chart review of 109 patients with moderate to severe COVID-19 and T2DM admitted from March 2020 to June 2021 was done. Logistic regression was done to determine predictors for hyperglycemia and poor variability.
Results: Of the 109 patients, 78% had hyperglycemia and poor variability and 22% had no poor outcomes. Chronic kidney disease (eOR 2.83, CI [1.07-7.46], p = 0.035) was associated with increased glycemic variability. In contrast, increasing eGFR level (eOR 0.97, CI [0.96-0.99], p = 0.004) was associated with less likelihood of increased variability. Hs-CRP (eOR 1.01, CI [1.00-1.01], p = 0.011), HbA1c (eOR 1.86, CI [1.23-2.82], p = 0.003), severe COVID-19 (eOR 8.91, CI [1.77-44.94], p = 0.008) and critical COVID-19 (eOR 4.42, CI [1.65-11.75], p = 0.003) were associated with hyperglycemia. Steroid use (eOR 71.17, CI [8.53-593.54], p<0.001) showed the strongest association with hyperglycemia.
Conclusion: Potential clinical, laboratory and inflammatory profiles were identified as predictors for poor glycemic control and variability outcomes. HbA1c, hs-CRP, and COVID-19 severity are predictors of hyperglycemia. Likewise, chronic kidney disease is a predictor of increased glycemic variability.
期刊介绍:
The Journal of the ASEAN Federation of Endocrine Societies (JAFES) is an OPEN ACCESS, internationally peer-reviewed, English language, medical and health science journal that is published in print two times a year by the ASEAN Federation of Endocrine Societies. It shall serve as the endocrine window between the ASEAN region and the world, featuring original papers and publishing key findings from specialists and experts of endocrinology.