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Blood sugar spike due to COVID-19 could kill even non-diabetics

Blood sugar spike due to COVID-19 could kill even non-diabetics
All patients hospitalised with COVID-91, including non-diabetics, should be tested for high blood sugar, suggest researchers.

Patients with abnormally high glucose levels were found to be more than twice as likely to die from COVID-19 than those with normal readings, independent of a diabetes diagnosis.

Written by Longjam Dineshwori |Published : November 24, 2020 12:40 PM IST

People with chronic medical conditions like diabetes, heart disease, cancer and respiratory diseases are known to be at increased risk of severe illness from COVID-19 and death due to the disease. Researchers now suggest that high blood sugar levels due to COVID-19 infection may even kill non-diabetics.

A study, published in the peer-reviewed open access journal Annals of Medicine, has warned that abnormally high blood sugar may worsen outcomes and mortality rates among COVID-19 patients, including those without diabetes.

High blood sugar or hyperglycaemia is a common problem for diabetics, but it can also be triggered by illness or injury. Abnormally high blood sugar has been identified as an important risk factor for death in COVID-19 patients.

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Hyperglycemia was also identified as a risk factor for high morbidity and mortality in people who contracted severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).

The link between hyperglycaemia and in-hospital mortality

The research team, including scientists from Juan Ramon Jimenez University Hospital in Spain, wanted to find out the association between blood sugar levels and in-hospital mortality in non-critically patients hospitalized with COVID-19.

For the study, the researchers analysed medical data of more than 11,000 non-critically ill patients from more than 100 hospitals in Spain. The patients aged 18 or above were admitted from March to the end of May. They were categorized into three groups relating to their blood sugar levels, ranging from normal to high (<140 mg/dl; 140-180 mg/dl; and> 180 mg/dl). Only 19% had an existing diabetes diagnosis.

According to the study results, patients with abnormally high glucose levels were more than twice as likely to die from the virus than those with normal readings, regardless of their diabetes status. This means no difference was found between death rates for those with pre-existing diabetes and those who did not have the disease. In-hospital mortality rates were highest among those with the greatest blood glucose levels. Patients who experienced hyperglycaemia also had an increased need for a ventilator and intensive care admission (ICU).

This adds to the growing evidence that hyperglycaemia is associated with a higher chance of death among COVID patients, independent of a diabetes diagnosis.

Hyperglycemia screening for all hospitalized with COVID-19

Based on the findings of their study, the researchers suggest that all patients hospitalized with COVID-19, including non-diabetics, should be screened for hyperglycemia and provided early treatment if their blood sugar levels are found to be high. They urge doctors not to overlook the condition, regardless of whether the patient has a prior history of diabetes or not.

The authors also pointed out that most people do not get themselves tested for diabetes regularly and therefore, many may have the disease without even knowing it. They indicated that many people classified as non-diabetic may be silently suffering from diabetes due to no diagnosis.

However, how exactly high blood sugar leads to higher death rates remains unclear. The researchers believe the condition could be another 'inflammatory bystander' or have a more direct effect on how COVID leads to complications and death.

In July this year, a study published in Diabetolgia also described hyperglycemia as an independent predictor of COVID-19 mortality, underscoring the importance of addressing elevated fasting blood glucose at an early stage.