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Continuous Glucose Monitoring

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COVID-19 & Diabetes

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Glucose Monitoring and Diabetes Management in the Time of Coronavirus Disease 2019

Source: Journal of Diabetes Science and Technology

Key Takeaway: We have learned that the coronavirus disease 2019 (COVID-19) pandemic is presenting the field of diabetes technology with challenges and opportunities. The challenges are difficult to overstate: in the United States, about 34% of patients hospitalized for COVID-19 have pre-existing diabetes, and patients with diabetes do far worse with COVID-19 than those without. The opportunities for diabetes technology are taking the form of stronger and better relationships within the diabetes community, expanded use of continuous glucose monitoring (CGM) and remote monitoring, a greater understanding of the disease as it relates to endocrine and metabolic disruption, and insights that may apply to the next public health crisis.

 


COVID-19 in People with Diabetes: Urgently Needed Lessons From Early Reports

Source: Diabetes Care

Key Takeaway: Digital technologies are providing remote access to educational and research meetings and, of course, to loved ones and friends who may be otherwise inaccessible. Until a proven vaccine and highly effective pharmacotherapy are developed, we need widespread testing of apparently well individuals to determine who has immunity from prior infection, who is at risk, and who is unknowingly infected. As the peak of COVID-19 begins to pass and we work to obtain better testing, pharmacotherapy, and ultimately a vaccine, we will enter a longer interval in which we must continue to support the most vulnerable populations, especially older people, those with diabetes or obesity, and those who lack the resources to limit day-today exposure to infection. We hope a growing sense of community will help in this task.

 


Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients with Diabetes in Wuhan, China: A Two-Center, Retrospective Study

Source: Diabetes Care

Key Takeaway: In summary, the findings of our study suggested that COVID-19 patients with diabetes had worse outcomes compared with the sex- and age-matched patients without diabetes. Diabetes was not independently associated with in-hospital death, while hypertension, cardiovascular disease, and chronic pulmonary disease played more important roles in contributing to the mortality of COVID19 patients. In-hospital death among COVID-19 patients with diabetes was associated with hypertension and advanced age, whereas only older age was independently associated with death among matched patients without diabetes. The need for early monitoring and supportive care should be addressed in these patients at high risks.

 


Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes

Source: Cell Metabolism

Key Takeaway: Type 2 diabetes (T2D) is a major comorbidity of COVID-19. However, the impact of blood glucose (BG) control on the degree of required medical interventions and on mortality in patients with COVID-19 and T2D remains uncertain. Thus, we performed a retrospective, multi-centered study of 7,337 cases of COVID-19 in Hubei Province, China, among which 952 had pre-existing T2D. We found that subjects with T2D required more medical interventions and had a significantly higher mortality (7.8% versus 2.7%; adjusted hazard ratio [HR], 1.49) and multiple organ injury than the non-diabetic individuals. Further, we found that well-controlled BG (glycemic variability within 3.9 to 10.0 mmol/L) was associated with markedly lower mortality compared to individuals with poorly controlled BG (upper limit of glycemic variability exceeding 10.0 mmol/L) (adjusted HR, 0.14) during hospitalization. These findings provide clinical evidence correlating improved glycemic control with better outcomes in patients with COVID-19 and pre-existing T2D.


Practical Recommendations for the Management of Diabetes in Patients with COVID-19

Source: The Lancet Diabetes & Endocrinology

Key Takeaway: Diabetes is one of the most important comorbidities linked to the severity of all three known human pathogenic coronavirus infections, including severe acute respiratory syndrome coronavirus 2. Patients with diabetes have an increased risk of severe complications including Adult Respiratory Distress Syndrome and multi-organ failure. Depending on the global region, 20–50% of patients in the coronavirus disease 2019 (COVID-19) pandemic had diabetes. Given the importance of the link between COVID-19 and diabetes, we have formed an international panel of experts in the field of diabetes and endocrinology to provide some guidance and practical recommendations for the management of diabetes during the pandemic. We aim to briefly provide insight into potential mechanistic links between the novel coronavirus infection and diabetes, present practical management recommendations, and elaborate on the differential needs of several patient groups.