Insights on Treating Diabetic Patients with COVID-19

There is a vast spectrum of symptoms present in people with COVID-19. While some people remain asymptomatic, there are several known pre-existing conditions (co-morbidities) that correlate with increased disease severity. In this D4P presentation, scientist Viktor Belay presents data from “Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes,” published in Cell Metabolism on April 30, 2020. The authors in this report set out to better understand the impact of COVID-19 in patients with type 2 diabetes through a retrospective study on affected patients in Hubei Province, China.

What you need to know:

At the time of this D4P presentation, there have been nearly 7 million reported cases of COVID-19 worldwide. The scientific and medical communities have been working around the clock to understand how different contexts can influence the recovery of patients with COVID-19 . Early on, it became clear that pre-existing conditions—such as high blood pressure, cardiovascular disease, and diabetes—are highly correlated with negative outcomes when combined with COVID-19. However, the specific details related to how the SARS-CoV-2 infection intertwines with these pre-existing conditions are not yet revealed.

In the scientific report covered here, by Viktor, we learn about COVID-19 patient outcomes in those who have type 2 diabetes. Given the degree of uncertainty regarding how to simultaneously treat these patients for both conditions, the authors conducted a retrospective longitudinal study that included over 7,000 patients from 19 different hospitals in Hubei Province, China. The authors in this study focus on admitted COVID-19 patients, and specifically look at the association between their plasma glucose levels and survival rates.

The following are the key terms defined in this D4P presentation, and are important for understanding the data presented in this D4P webinar.

Diabetes

Diabetes is a metabolic disorder where the body’s ability to process sugar is disrupted. The major molecular players of diabetes are the molecules glucose and insulin. Glucose is a simple sugar (carbohydrate) that serves as an important energy source for all living organisms, and is found in most foods that we eat. Insulin is a protein hormone produced by the pancreas that regulates how glucose is used and stored in our bodies. Patients with diabetes have trouble regulating the level of glucose in their blood resulting from issues with insulin production and/or action.

There are several different categories for diabetes. In this report, the researchers focus on COVID-19 patients with type 2 diabetes, also known as adult-onset or diet-induced diabetes. More specifically, the authors of this study examined how regulation of blood glucose levels in diabetic patients admitted to the hospital with COVID-19 impacted their survival and recovery.

Co-morbidity

A co-morbidity is a medical condition with symptoms that overlap and potentially exacerbate the symptoms of another medical condition. Given the higher rates of mortality for COVID-19 patients with the pre-existing condition of type 2 diabetes, we can consider type 2 diabetes to be a co-morbidity for COVID-19.

Statistical Significance and Significance Testing

Statistical significance is a mathematical measurement of the expectedness or ‘chance’ of an observed effect. Significance testing refers to the formal methods used to determine statistical significance. In this paper, the authors set out to ascertain how differences in blood glucose (BG) levels in patients with type 2 diabetes impacted their ability to overcome COVID-19. They used statistical measurements to understand if the observed outcomes were due to random chance, or if differences in BG management actually impacted patient outcomes.