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Glycemia, Beta-Cell Function and Sensitivity to Insulin in Mildly to Critically Ill Covid-19 Patients.
Ilias, Ioannis; Diamantopoulos, Aristidis; Pratikaki, Maria; Botoula, Efthymia; Jahaj, Edison; Athanasiou, Nikolaos; Tsipilis, Stamatios; Zacharis, Alexandros; Vassiliou, Alice G; Vassiliadi, Dimitra A; Kotanidou, Anastasia; Tsagarakis, Stylianos; Dimopoulou, Ioanna.
  • Ilias I; Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou Hospital, GR-11521 Athens, Greece.
  • Diamantopoulos A; Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, GR-10676 Athens, Greece.
  • Pratikaki M; Department of Microbiology, Evangelismos Hospital, GR-10676 Athens, Greece.
  • Botoula E; Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, GR-10676 Athens, Greece.
  • Jahaj E; First Department of Critical Care Medicine & Pulmonary Services, Medical School of National & Kapodistrian University of Athens, Evangelismos Hospital, GR-10676 Athens, Greece.
  • Athanasiou N; First Department of Critical Care Medicine & Pulmonary Services, Medical School of National & Kapodistrian University of Athens, Evangelismos Hospital, GR-10676 Athens, Greece.
  • Tsipilis S; Department of Pulmonary Medicine, Evangelismos Hospital, GR-10676 Athens, Greece.
  • Zacharis A; First Department of Critical Care Medicine & Pulmonary Services, Medical School of National & Kapodistrian University of Athens, Evangelismos Hospital, GR-10676 Athens, Greece.
  • Vassiliou AG; First Department of Critical Care Medicine & Pulmonary Services, Medical School of National & Kapodistrian University of Athens, Evangelismos Hospital, GR-10676 Athens, Greece.
  • Vassiliadi DA; Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, GR-10676 Athens, Greece.
  • Kotanidou A; First Department of Critical Care Medicine & Pulmonary Services, Medical School of National & Kapodistrian University of Athens, Evangelismos Hospital, GR-10676 Athens, Greece.
  • Tsagarakis S; Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, GR-10676 Athens, Greece.
  • Dimopoulou I; First Department of Critical Care Medicine & Pulmonary Services, Medical School of National & Kapodistrian University of Athens, Evangelismos Hospital, GR-10676 Athens, Greece.
Medicina (Kaunas) ; 57(1)2021 Jan 14.
Article in English | MEDLINE | ID: covidwho-1028880
Semantic information from SemMedBD (by NLM)
1. Insulin TREATS COVID-19
Subject
Insulin
Predicate
TREATS
Object
COVID-19
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Blood Glucose INTERACTS_WITH Insulin
Subject
Blood Glucose
Predicate
INTERACTS_WITH
Object
Insulin
4. Insulin TREATS Patients
Subject
Insulin
Predicate
TREATS
Object
Patients
5. glucose TREATS COVID-19
Subject
glucose
Predicate
TREATS
Object
COVID-19
6. glucose TREATS Patients
Subject
glucose
Predicate
TREATS
Object
Patients
7. Hyperglycemia PROCESS_OF Patients
Subject
Hyperglycemia
Predicate
PROCESS_OF
Object
Patients
8. Diabetes PROCESS_OF Patients
Subject
Diabetes
Predicate
PROCESS_OF
Object
Patients
9. glucose compared_with Insulin
Subject
glucose
Predicate
compared_with
Object
Insulin
10. glucose TREATS Survivors
Subject
glucose
Predicate
TREATS
Object
Survivors
11. Insulin Secretion PROCESS_OF Patients
Subject
Insulin Secretion
Predicate
PROCESS_OF
Object
Patients
12. Insulin TREATS COVID-19
Subject
Insulin
Predicate
TREATS
Object
COVID-19
13. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
14. Blood Glucose INTERACTS_WITH Insulin
Subject
Blood Glucose
Predicate
INTERACTS_WITH
Object
Insulin
15. Insulin TREATS Patients
Subject
Insulin
Predicate
TREATS
Object
Patients
16. glucose TREATS COVID-19
Subject
glucose
Predicate
TREATS
Object
COVID-19
17. glucose TREATS Patients
Subject
glucose
Predicate
TREATS
Object
Patients
18. Hyperglycemia PROCESS_OF Patients
Subject
Hyperglycemia
Predicate
PROCESS_OF
Object
Patients
19. Diabetes PROCESS_OF Patients
Subject
Diabetes
Predicate
PROCESS_OF
Object
Patients
20. glucose compared_with Insulin
Subject
glucose
Predicate
compared_with
Object
Insulin
21. glucose TREATS Survivors
Subject
glucose
Predicate
TREATS
Object
Survivors
22. Insulin Secretion PROCESS_OF Patients
Subject
Insulin Secretion
Predicate
PROCESS_OF
Object
Patients
ABSTRACT
Background and

objectives:

Critically and non-critically ill patients with SARS-CoV-2 infection (Covid-19) may present with higher-than-expected glycemia, even in the absence of diabetes. With this study we aimed to assess glucose, glycemic gap (GlyG) and insulin secretion/sensitivity measures in patients with Covid-19. Materials and

Methods:

We studied, upon admission, 157 patients with Covid-19 (84 in wards and 73 in intensive care units; ICU); 135 had no history of diabetes. We measured blood glucose upon admission as well as glycated hemoglobin (A1c), plasma insulin and C-peptide. We calculated the GlyG and the Homeostasis Model Assessment 2 (HOMA2) estimates of steady state beta cell function (HOMA2%B) and insulin sensitivity (HOMA2%S). Statistical assessment was done with analysis or the Kruskal-Wallis test.

Results:

Compared to patients in the wards without diabetes, patients with diabetes in the wards, as well as patients in the ICU (without or with diabetes) had higher admission glycemia. The GlyG was significantly higher in patients without diabetes in the ICU compared to patients without diabetes in the wards, while HOMA2%B based on glucose and insulin was significantly higher in the ICU patients compared to patients in the wards. Of all the parameters, HOMA2%S based on C-peptide/glucose was higher in survivors (n = 133).

Conclusions:

In our series of patients with Covid-19, a substantial number of patients with and without diabetes had admission hyperglycemia and those who were critically ill may have had compromised insulin secretion and lowered sensitivity to insulin. These findings lend credence to reports of association between Covid-19 and hyperglycemia/secondary diabetes.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Blood Glucose / C-Peptide / Insulin Resistance / COVID-19 / Insulin Type of study: Diagnostic study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: Medicina57010068

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Blood Glucose / C-Peptide / Insulin Resistance / COVID-19 / Insulin Type of study: Diagnostic study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: Medicina57010068