Clinical characteristics and managing type 2 diabetes during the COVID-19

Background: Diabetes mellitus (DM) is one of the most common comorbidities in people with COVID-19 infection. Inadequate glycemic control is related to high inflammation, hypercoagulability, and mortality in COVID-19 patients. Patients admitted to hospital for COVID-19 might need modifications to their diabetes therapy. The study was aimed at evaluating the association of clinical presentation and glycemic management in patients with type 2 diabetes and COVID-19. Methods: This retrospective study included 60 patients with type 2 DM and COVID-19, distributed into three groups: group 1 oral agents - 32 patients, group 2 oral agents and basal insulin - 15 patients, group 3 intensive insulin treatment - 13 patients. We measured laboratory parameters, evaluated clinical presentation, and followed glycemic treatment during hospitalization. Results: Patients on oral antidiabetic drugs had better glycemic control before hospitalization, shorter duration of DM, and normal weight according to BMI compared with the other two groups. The most common symptoms of COVID-19 were: fever, cough, and fatigue. For better glycemic control we added basal insulin in 15 patients in group 1 (50%) and 9 patients need intensive insulin treatment in group 2 (60%). We discounted metformin in two patients in group 1 and three patients in group 2. A total of 7 patients died (11.6 %) during hospitalization, including 3 deaths in group 2 (5%), and 4 deaths in group 3 (6.6%). Conclusions: Poorer glycemic control before COVID-19 is associated with higher inflammation parameters, worse outcomes, and required modification of their treatment during hospitalization.