scholarly journals Clinical Outcomes of Non-diabetic COVID-19 Patients with Different Blood Glucose Levels: A Nationwide Turkish Study (TurCoGlycemia)

Author(s):  
Cem Haymana ◽  
Ibrahim Demirci ◽  
Ilker Tasci ◽  
Erman Cakal ◽  
Serpil Salman ◽  
...  

Abstract Purpose New coronavirus disease 2019 (COVID-19) has a worse prognosis in patients with diabetes. However, there are insufficient data about the effect of hyperglycemia on COVID-19 prognosis in non-diabetic patients. This study aimed to investigate the relationship between random blood glucose levels measured at the time of diagnosis and prognosis of COVID-19 disease in non-diabetic patients. Methods A nationwide retrospective cohort of non-diabetic patients with confirmed COVID-19 infection from 11 March to 30 May 2020 in the Turkish Ministry of Health database was investigated. The patients were stratified into three groups according to blood glucose levels which were <100 mg/dL in group-1, in the range of 100-139 mg/dl in group-2, and the range of 140-199 mg/dl in group-3. Clinical characteristics and outcomes were compared among the groups. The primary outcome was mortality. Results A total of 12,817 non-diabetic patients (median age [IQR]: 44 [25] years, females: 50.9%) were included. Patients in group-2 (5%) and group-3 (14%) had higher mortality rates than patients in group-1 (2.1%). The rates of hospitalization, hospital stays longer than 8 days, intensive care unit (ICU) admission, ICU stay more than 6 days, and mechanical ventilation were also significantly higher in group-3 patients. Likewise, glucose levels in the range of 140-199 mg/dL were an independent associate of mortality and composite of ICU admission and/or mechanical ventilation. ConclusionHyperglycemia at the time of COVID-19 diagnosis is associated with poor prognosis in non-diabetic patients. Clinicians should be more careful in the treatment of non-diabetic COVID-19 patients with hyperglycemia.

2021 ◽  
Vol 2 (2) ◽  
pp. 106-113
Author(s):  
P. O. Opara ◽  
V. H. A. Enemor ◽  
F. U. Eneh ◽  
F. C. Emengaha

The blood glucose- lowering potentials of ethanol leaf extract of Annona muricata were studied. Thirty wistar albino rats were divided into six groups of five rats per group. Group 1 served as “Normal control” animals and received normal rat pellets and water. Diabetes mellitus was induced in Groups 2, 3, 4, and 5 by intraperitoneal injection of alloxan (130 mg/kg). Group 6 rats were administered with 400 mg/kg daily of the extract without induction; group 3 rats were treated with glibenclamide (5 mg/kg body weight), groups 4 and 5 received 200 mg/kg and 400 mg/kg body weight of A. muricata leaf extract daily respectively throughout the duration of the experiment of 14 days. Group 2 rats were induced but not treated with any drug, thus it served as the “Negative control” group. Quantitative phytochemical analysis of the leaf extract was carried out using the Association of Official Analytical Chemists (AOAC) methods. Acute toxicity test of the leaf extract of A. muricata was determined using 12 rats by Lorke’s toxicity testing method. The blood glucose levels of the animals in each group were determined using Accu-chek test strip method. The weights of the animals were determined using a standard electronic weighing balance. The result of the quantitative phytochemical analysis of the leaf showed that the ethanol leaf extract contains the following: phenols (74 mg/100 g), flavonoids (3.70 mg/100 g), tannins (2.95 mg/100 g), oxalate (6.48 mg/100 g), terpenoid (13.88 mg/100 g), phytates (130 mg/100 g), saponins (6800 mg/100 g), alkaloids (570 mg/100 g), cardiac glycoside (1690 mg/100g). Acute toxicity studies showed that LD50 was 3807.89 mg/kg body weight. The results of the average blood glucose levels (mg/dl) of the rats in each group were group 1, 82.6071±7.7524, group 2, 309.3571±163.6923, group 3, 226.7143±132.8182, group 4, 146.5000±140.1465, group 5, 150.4783±81.8340, and group 6, 83.4643±12.5329 for each group respectively. The average body weights of the rats in each group were group 1, 192.8571±22.5844, group 2, 185.7143±33.6759, group 3, 177.1429±36.67500, group 4, 219.2857±21.2908, group 5, 119.5455±23.5993, and group 6, 191.7857±25.2475. The findings from this study suggest that ethanolic leaf extract of A. muricata has notable effect in lowering blood glucose levels in diabetic rats and is a more potent drug in the treatment and management of diabetes mellitus and oxidative stress- related diseases.


2020 ◽  
Vol 14 (4) ◽  
pp. 206-213
Author(s):  
Shruthi S Hegde ◽  
Atul P Sattur ◽  
Anil Bapu Bargale ◽  
Gayathri S Rao ◽  
Rajeeth S Shetty ◽  
...  

Background. A correlation has been noted between diabetes mellitus (DM) and changes in the oral cavity. The present study aimed to estimate, compare, and correlate serum and salivary glucose and IgA levels and salivary candidal carriage in diabetic and non-diabetic individuals. Methods. Eighty-eight subjects were categorized into three groups: group 1 (controlled DM; n=27), group 2 (uncontrolled DM; n=32) and group 3 (non-diabetics; n=29). Serum and salivary glucose levels were estimated by glucose oxidase/peroxidase method, serum and salivary IgA by a diagnostic kit, and candidal colonization by inoculating samples into Sabouraud dextrose agar plate. Statistical analyses were carried out by one-way ANOVA, post hoc Tukey tests, and Pearson’s correlation coefficient. Results. Significant elevation of serum IgA levels was observed in group 2 compared to group 3 and significant decreases in salivary IgA levels in groups 1 and 2. The candidal carriage was significantly higher in group 2 compared to group 3. Serum glucose and salivary IgA levels showed a significant correlation in group 1. There was a positive correlation between serum/ salivary glucose and serum/salivary IgA levels in group 2. In addition, there was a significant correlation between serum glucose and serum IgA levels in group 3. Conclusion. Saliva could be a potential, non-invasive diagnostic tool to estimate glucose levels. The evaluation of salivary components, like IgA, might be useful in diagnosing and managing oral manifestations in diabetic individuals. Elevated salivary glucose levels contribute to elevated candidal carriage, making individuals susceptible to oral candidiasis.


2021 ◽  
Vol 12 ◽  
Author(s):  
Wenjun Wang ◽  
Zhonglin Chai ◽  
Mark E. Cooper ◽  
Paul Z. Zimmet ◽  
Hua Guo ◽  
...  

BackgroundWe aimed to understand how glycaemic levels among COVID-19 patients impact their disease progression and clinical complications.MethodsWe enrolled 2,366 COVID-19 patients from Huoshenshan hospital in Wuhan. We stratified the COVID-19 patients into four subgroups by current fasting blood glucose (FBG) levels and their awareness of prior diabetic status, including patients with FBG&lt;6.1mmol/L with no history of diabetes (group 1), patients with FBG&lt;6.1mmol/L with a history of diabetes diagnosed (group 2), patients with FBG≥6.1mmol/L with no history of diabetes (group 3) and patients with FBG≥6.1mmol/L with a history of diabetes diagnosed (group 4). A multivariate cause-specific Cox proportional hazard model was used to assess the associations between FBG levels or prior diabetic status and clinical adversities in COVID-19 patients.ResultsCOVID-19 patients with higher FBG and unknown diabetes in the past (group 3) are more likely to progress to the severe or critical stage than patients in other groups (severe: 38.46% vs 23.46%-30.70%; critical 7.69% vs 0.61%-3.96%). These patients also have the highest abnormal level of inflammatory parameters, complications, and clinical adversities among all four groups (all p&lt;0.05). On day 21 of hospitalisation, group 3 had a significantly higher risk of ICU admission [14.1% (9.6%-18.6%)] than group 4 [7.0% (3.7%-10.3%)], group 2 [4.0% (0.2%-7.8%)] and group 1 [2.1% (1.4%-2.8%)], (P&lt;0.001). Compared with group 1 who had low FBG, group 3 demonstrated 5 times higher risk of ICU admission events during hospitalisation (HR=5.38, 3.46-8.35, P&lt;0.001), while group 4, where the patients had high FBG and prior diabetes diagnosed, also showed a significantly higher risk (HR=1.99, 1.12-3.52, P=0.019), but to a much lesser extent than in group 3.ConclusionOur study shows that COVID-19 patients with current high FBG levels but unaware of pre-existing diabetes, or possibly new onset diabetes as a result of COVID-19 infection, have a higher risk of more severe adverse outcomes than those aware of prior diagnosis of diabetes and those with low current FBG levels.


Author(s):  
Shilpa B. N. ◽  
Shashikala G. H. ◽  
Siddesh . ◽  
Mallesh P.

Background: Diabetes mellitus is the fifth leading cause of death worldwide and is one of the common co-morbid conditions associated with coronary artery disease (CAD). The overall prevalence of CAD is 7.4% but the prevalence of CAD in diabetics is 9%. Hence treatment of hyperglycemia is a key goal of secondary preventive therapy with a target of reducing HbA1c to <7%. The risk of CAD has been reported to occur 2 to3 decades prior in diabetics compared to non-diabetics. Hence discovery of drugs with potential role in both diabetes and CAD seems to be necessary. Ranolazine is a novel oral anti anginal drug known to reduce HbA1c and fasting blood glucose levels in angina patients with diabetes. The objective of this study is to show the effect of ranolazine (antianginal drug) on HbA1c and fasting blood glucose levels in diabetic patients with chronic angina.Methods: Patients were divided into: Group 1 continued with previous antidiabetic drugs and antianginal drugs. Group 2 were prescribed Tab ranolazine 1000mg b.d (orally) as add on therapy along with previous antidiabetic drugs and antianginal drugs.Results: There was a significant reduction in HbA1c and FBS levels in Group 2 patients who were on ranolazine. Reduction of HbA1c in group1 and Group 2 was 0.21±0.65% and 1.30±1.16% respectively. Reduction of FBS in group1 and group2 was 10.66±27.80mg/dl and 29.97±31.49mg/dl respectively.Conclusions: From the present study we can conclude that ranolazine, an antianginal drug when given at a dose of 1000mg bd in diabetic patients with chronic angina reduces HbA1c and FBS levels. 


Antioxidants ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 39
Author(s):  
Inn-Chi Lee ◽  
Jiann-Jou Yang ◽  
Ying-Ming Liou

The antioxidant defense system is involved in the pathogenesis of neonatal hypoxic-ischemic encephalopathy (HIE). To analyze the relationship between first serum blood glucose levels and outcomes in neonatal HIE, seventy-four patients were divided, based on the first glucose level, into group 1 (>0 mg/dL and <60 mg/dL, n =11), group 2 (≥60 mg/dL and <150 mg/dL, n = 49), and group 3 (≥150 mg/dL, n = 14). Abnormal glucose levels had poor outcomes among three groups in terms of the clinical stage (p = 0.001), brain parenchymal lesion (p = 0.004), and neurodevelopmental outcomes (p = 0.029). Hearing impairment was more common in group 3 than in group 1 (p = 0.062) and group 2 (p = 0.010). The MRI findings of group 3 exhibited more thalamus and basal ganglion lesions than those of group 1 (p = 0.012). The glucose level was significantly correlated with clinical staging (p< 0.001), parenchymal brain lesions (p = 0.044), hearing impairment (p = 0.003), and neurodevelopmental outcomes (p = 0.005) by Pearson’s test. The first blood glucose level in neonatal HIE is an important biomarker for clinical staging, MRI findings, as well as hearing and neurodevelopment outcomes. Hyperglycemic patients had a higher odds ratio for thalamus, basal ganglia, and brain stem lesions than hypoglycemic patients with white matter and focal ischemic injury. Hyperglycemia can be due to prolonged or intermittent hypoxia and can be associated with poor outcomes.


2020 ◽  
Vol 16 (4) ◽  
pp. 301-312 ◽  
Author(s):  
Jyoti Singh ◽  
Prasad Rasane ◽  
Sawinder Kaur ◽  
Vikas Kumar ◽  
Kajal Dhawan ◽  
...  

Diabetes is a globally prevalent chronic metabolic disease characterized by blood glucose levels higher than the normal levels. Sugar, a common constituent of diet, is also a major factor often responsible for elevating the glucose level in diabetic patients. However, diabetic patients are more prone to eat sweets amongst the human population. Therefore, we find a popular consumption of zero or low-calorie sweeteners, both natural and artificial. But, the uses of these sweeteners have proved to be controversial. Thus, the purpose of this review was to critically analyze and highlight the considerations needed for the development of sugar-free or low-calorie products for diabetic patients. For this purpose, various measures are taken such as avoiding sugary foods, using natural nectar, artificial sweeteners, etc. It cannot be ignored that many health hazards are associated with the overconsumption of artificial sweeteners only. These sweeteners are high-risk compounds and a properly balanced consideration needs to be given while making a diet plan for diabetic patients.


2009 ◽  
Vol 3 ◽  
pp. CMC.S2289 ◽  
Author(s):  
Taysir S. Garadah ◽  
Salah Kassab ◽  
Qasim M. Al-Shboul ◽  
Abdulhai Alawadi

Recent studies indicated a high prevalence of hyperglycemia in non-diabetic patients presenting with acute coronary syndrome (ACS). However, the threshold of admission glucose (AG) as a predictor of adverse events in ACS is unclear. Objective The aim of this study was to assess the threshold of admission glucose (AG) as a predictor of adverse events including Major Acute Cardiac Events (MACE) and mortality, during the first week of admitting patients presenting with ACS. Material and Methods The data of 551 patients with ACS were extracted and evaluated. Patients were stratified according to their blood glucose on admission into three groups: group 1: <7 mmol/L (n = 200, 36.3%) and group 2: >7 mmol/L and <15 mmol/L (n = 178, 32.3%) and group 3: ≥15 mmol/L (n = 173, 31.4%). Stress hyperglycemia was arbitrarily defined as AG levels > 7 mmol/L (group 2 and 3). Patients with ACS were sub-divided into two groups: patients with unstable angina (UA, n = 285) and those with ST segment elevation myocardial Infarction (STEMI, n = 266) and data were analyzed separately using multiple regression analysis. Results The mean age of patients was 59.7 ± 14.8 years and 63% were males. The overall mortality in the population was 8.5% (5.4% in STEMI and 3.1% in UA) patients. In STEMI patients, the odds ratio of stress hyperglycemia as predictor of mortality in group 3 compared with group 1 was 3.3 (CI 0.99-10.98, P < 0.05), while in group 2 compared with group 1 was 2.4 (CI: 0.75-8.07, P = 0.065) after adjustment for age and sex. Similarly, in UA patients, the odds ratio of stress hyperglycemia in group 3 compared with group 1 was 2.7 (CI 0.37-18.98, P < 0.05), while in group 2 compared with group 1 was 2.4 (CI: 0.4-15.2, P = 0.344) after adjustment for age and sex. The incidence of more than 2 MACE in both STEMI and UA patients was higher in group 3 compared with the other two groups. Regression analysis showed that history of DM, high level of LDL cholesterol, high level of HbA1c, and anterior infarction were significant predictors of adverse events while other risk factors such as BMI, history of hypertension and smoking were of no significance. Conclusion This study indicates that the stress hyperglycemia on admission is a powerful predictor of increased major adverse events and hospital mortality in patients with acute coronary syndrome.


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