COVID-19 入院时首次发现的糖尿病范围高血糖患者的长期预后:单中心观察研究

IF 1.1 Q4 PRIMARY HEALTH CARE Journal of Family Medicine and Primary Care Pub Date : 2024-07-26 DOI:10.4103/jfmpc.jfmpc_140_24
Ketan Agarwal, Ravi Kirti, Shyama Shyama, Pragya Kumar, Ratnadeep Biswas, V. Ojha
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摘要

摘要 据首次报道,许多 2019 年冠状病毒病(COVID-19)患者在住院期间出现了糖尿病范围的高血糖。本研究旨在确定这类患者中真正患有新发糖尿病而非急性病期间一过性高血糖的比例。 这项描述性研究包括在因 COVID-19 入院时或入院期间首次发现糖尿病范围内的高血糖,但之前没有糖尿病病史的患者。研究方案包括患者身份识别、病例记录数据和电话随访。记录患者出院至少两周后或最后一次服用类固醇(以较晚者为准)时的血糖水平,并将患者分为糖尿病患者、糖尿病前期患者和非糖尿病患者。约 63 名(73.3%)患者血糖正常。在 10 名新发糖尿病患者中,有 8 人(80%)正在接受治疗,其中 5 人(50%)达到了目标血糖水平。研究发现,新发糖尿病与年龄、性别、合并症、重症监护住院时间和类固醇用量的关系没有统计学意义(P 值分别为 0.809、0.435、0.324、0.402 和 0.289)。 虽然大多数患有糖尿病范围高血糖的后 COVID 患者在急性病缓解后血糖恢复正常,但每 10 人中就有 1 人发展为新发糖尿病,另外每 7 人中就有 1 人糖耐量受损。因此,对这类患者进行定期血糖筛查至关重要,同时应鼓励他们改变生活方式,以降低罹患糖尿病的风险。这项研究存在一些局限性,如失去随访和依赖单组血糖读数进行分类。
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Long-term outcome of patients with diabetic-range hyperglycemia first detected during admission for COVID-19: A single-center observational study
ABSTRACT Diabetic-range hyperglycemia has been reported for the first time in many patients during their hospitalization with coronavirus disease 2019 (COVID-19). This study was undertaken to determine the proportion of such patients who actually have new-onset diabetes mellitus rather than transient hyperglycemia during acute illness. This descriptive study included patients with diabetic-range hyperglycemia first detected at or during admission for COVID-19 but no prior history of diabetes. The study protocol involved patient identification, data recording from the case-notes, and telephonic follow-ups. Blood sugar levels done at least two weeks after discharge or the last dose of steroids, whichever was later, were recorded, and patients were categorized as diabetic, pre-diabetic, or non-diabetic accordingly Out of 86 patients, ten (11.6%) were found to have developed diabetes, and 13 (15.1%) had pre-diabetes on follow-up. About 63 (73.3%) patients had become normoglycemic. Eight (80%) out of the ten patients with new-onset diabetes were on treatment, with five (50%) achieving the target glycemic levels. The associations of new-onset diabetes with age, gender, comorbidities, intensive care stay, and steroid administration were not found to be statistically significant (p-values 0.809, 0.435, 0.324, 0.402, and 0.289, respectively). While a majority of post-COVID patients with diabetic-range hyperglycemia returned to a normoglycemic state after the acute illness had settled down, one in ten developed new-onset diabetes, and an additional one in seven had impaired glucose tolerance. Thus, regular glucose screening is crucial for such patients and lifestyle modifications should be encouraged to reduce the risk of diabetes. Loss to follow-up and reliance on a single set of blood sugar readings for classification were some of the limitations of this study.
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