Continuous glucose monitoring profile in COVID-19 patients with and without diabetes receiving methylprednisolone.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrine Pub Date : 2024-11-01 Epub Date: 2024-05-31 DOI:10.1007/s12020-024-03841-0

Xingxing He, Guangchen Duan, Jingyi Lu, Yaxin Wang, Jinghao Cai, Yiqing Tong, Wei Wu, Xiaojing Ma, Qiming Feng, Jian Zhou

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Abstract

Purpose: Methylprednisolone is widely used during the COVID-19 epidemic. We aimed to evaluate the glucose profile of COVID-19 patients with and without diabetes receiving methylprednisolone.

Methods: 36 patients with COVID-19 admitted to hospital were included: 17 with and 19 without diabetes. Methylprednisolone 40 mg was administered at about 9:00 a.m. Glucose levels were assessed by blinded intermittently scanned continuous glucose monitoring (isCGM) for an average of 6.8 ± 2.4 days. Excess hyperglycemia was defined as time above range (TAR) > 10.0 mmol/L (TAR_>10.0) ≥ 25%, or TAR > 13.9 mmol/L (TAR_>13.9) ≥ 10%.

Results: Glucose management indicator (GMI) was significantly higher than the admission glycated hemoglobin A_1c (HbA_1c) level in patients without diabetes [6.7 (6.1-7.0) % vs. 5.9 (5.9-6.1) %, P < 0.001], while no significant difference was found in patients with diabetes [9.0 (7.5-9.5) % vs. 8.9 (7.5-10.2) %, P > 0.05]. The difference between GMI and HbA_1c (∆GMI-HbA_1c) in patients without diabetes was significantly higher than in patients with diabetes [0.7 (0.2-1.0) % vs. -0.2 (-1.5-0.5) %, P = 0.005]. The circadian patterns of glucose were similar in the two groups. In patients without diabetes, excess hyperglycemia occurred in 31.6% (6/19) of participants, with 31.6% (6/19) having a TAR_>10.0 ≥ 25%, while 21.1% (4/19) had a TAR_>13.9 ≥ 10%.

Conclusion: The impact of methylprednisolone on glycemia was more pronounced in COVID-19 patients without diabetes, compared to those with diabetes. A significant burden of methylprednisolone-induced hyperglycemia was observed in patients without diabetes.

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接受甲基强的松龙治疗的 COVID-19 型糖尿病患者和非糖尿病患者的连续血糖监测概况。

目的：甲基强的松龙在COVID-19流行期间被广泛使用。我们旨在评估接受甲基强的松龙治疗的 COVID-19 患者的血糖情况：方法：纳入36名住院的COVID-19患者：17名糖尿病患者和19名非糖尿病患者。通过盲法间歇扫描连续血糖监测（isCGM）评估血糖水平，平均为 6.8 ± 2.4 天。过量高血糖的定义是超过量程时间（TAR）> 10.0 mmol/L (TAR>10.0) ≥ 25%，或 TAR>13.9 mmol/L (TAR>13.9) ≥ 10%：无糖尿病患者的血糖管理指标（GMI）明显高于入院时的糖化血红蛋白 A1c（HbA1c）水平[6.7 (6.1-7.0) % vs. 5.9 (5.9-6.1) %，P 0.05]。无糖尿病患者的 GMI 与 HbA1c 之间的差异（∆GMI-HbA1c）明显高于糖尿病患者[0.7 (0.2-1.0) % vs. -0.2 (-1.5-0.5) %，P = 0.005]。两组患者的昼夜血糖模式相似。在无糖尿病的患者中，31.6%（6/19）的参与者出现过量高血糖，其中 31.6%（6/19）的 TAR>10.0 ≥ 25%，而 21.1%（4/19）的 TAR>13.9 ≥ 10%：结论：与糖尿病患者相比，甲基强的松龙对 COVID-19 患者血糖的影响更为明显。在无糖尿病的患者中，观察到甲基强的松龙诱发的高血糖负担很重。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.