A retrospective observational study in people infected with COVID-19 established a clear association between high three-month average sugar levels (HbA1c) and disease severity in type 2 diabetics.

The results, recently published in the peer-reviewed journal International Journal of Scientific Studies, suggested that the prognosis for the severity of COVID-19 in diabetic patients showed a higher risk based on an HbA1c level of 9% or more.

“Uncontrolled type 2 diabetes may be responsible for a higher overall hospitalization rate for COVID-19 infection,” says its author V. Balaji, of Dr. V. Seshiah Diabetes Care and Research Institute. He goes on to suggest that focusing on pre-existing comorbid risk factors in diabetic patients can be used to manage the severity of viral infection and may minimize the socio-economic burden.

A total of 120 post-COVID type 2 diabetes patients were included in the study conducted between March and October 2020, of which 102 were hospitalized and 18 were quarantined at home depending on the severity of COVID-19. Of the hospitalized patients, the majority were men with other pre-existing co-morbidities, usually hypertension and heart problems. All recovered from the infection.

“Using the pre-infection glycemic control data, we found that HbA1c was a clear predictor of the severity of COVID-19,” the study noted, citing other clinical features that were also significantly related to hospitalization, including gender, age, pre-existing conditions such as obesity, hypertension, thyroid and cardiovascular disease. Unexpectedly, obesity and male gender were not associated with hospitalization, although they were suggested as risk factors in previous studies. Patients with long-term uncontrolled HbA1c (greater than 9%) need more attention as they are prone to hospitalization and severe illness.

The results of the present study will help plan a comprehensive support strategy for people with diabetes in the healthcare sector and define regular monitoring of sugar and HbA1c levels as the cornerstone of interventions.