Long-Term Glycemic Control Cuts Risk for Severe COVID-19 With T2DM
Additionally, use of corticosteroids or combo of metformin and insulin significantly cut intensive care risk
TUESDAY, Dec. 7, 2021 (HealthDay News) -- Two- to three-year longitudinal glycemic levels are independently associated with COVID-19-related severity in people with type 2 diabetes, according to a study recently published in BMJ Open Diabetes Research & Care.
Bowen Wang, from Optum Health in Eden Prairie, Minnesota, and colleagues assessed associations of longitudinal glycated hemoglobin (HbA1c) and common medications (metformin, insulin, ACE inhibitors [ACEIs], angiotensin receptor blockers [ARBs], and corticosteroids) with COVID-19 severity in people with type 2 diabetes. The OptumLabs Data Warehouse (January 2017 to November 2020) was used to identify 16,504 individuals with type 2 diabetes and COVID-19.
The researchers found that two- to three-year longitudinal glycemic control was significantly associated with COVID-19-related severity (adjusted hazard ratios, 1.12 per 1 percent increase and 1.48 for those with poor [HbA1c, ≥9 percent] versus adequate glycemic control [HbA1c, 6 to 9 percent]). There was a significant reduction in intensive care use associated with corticosteroids and the combined use of insulin and metformin. No reduced risk for intensive care was seen with use of ACEIs or ARBs.
"We present a potential method to use HbA1c history, which presented a stronger association with COVID-19 severity than single-point HbA1c, to identify in advance those more at risk of intensive care due to COVID-19 in the type 2 diabetes population," the authors write.