15 December 2020 - - US-based insulin management software provider Glytec has posted the results of the first COVID-19 research to study the window of opportunity for treating hospitalized patients with hyperglycemia or diabetes, the company said.

The peer-reviewed study, published in Diabetes Care, the journal of the American Diabetes Association, found a higher risk of mortality for patients that did not achieve target blood glucose levels soon after admission.

This includes a sevenfold mortality risk for non-ICU patients with severe hyperglycemia after 48 to 72 hours.

Many studies have shown that target blood glucose levels can be consistently achieved within as little as six hours for ICU patients using intravenous insulin and within two days for non-ICU patients using standard subcutaneous basal-bolus insulin regimens.

This study defined target blood glucose as 140-180 mg/dL, which the American Diabetes Association and the American Association of Clinical Endocrinologists recommend for a majority of hospitalized patients.

In this COVID-19 study, however, more than half of patients in the ICU and non-ICU did not achieve target blood glucose levels within the first two or three days.

The study found that reaching a glucose value of 140 mg/dL or 141-180 mg/dL within two days after ICU admission or between two and three days in the non-ICU setting, respectively, is associated with reduced mortality.

This is statically significant in the non-ICU setting and trending toward significance in the ICU population.

The greater survival of individuals with better control after admission, compared with patients with uncontrolled glucose levels (greater than 250 mg/dL), is clinically meaningful and indicates the need to start treatment of hyperglycemia on admission.

The research was conducted using pooled data in the Glytec national database from patients in 91 hospitals across 12 states.

The database included 9,959 patients with COVID-19 positive laboratory tests and blood sugar measurements from March 1 to May 8, 2020, when the analysis was conducted.

After omitting patients, including those admitted for less than 24 hours, those under 18 years of age, and active admissions (those who had neither died nor been discharged), 1,601 patients were included in the final analysis.

Only 12% of the study population used commercial glucose management software, and the study did not analyze this detail.

The full, peer-reviewed paper, "Association Between Achieving Inpatient Glycemic Control and Clinical Outcomes in Hospitalized Patients with COVID-19: A Multicenter, Retrospective Hospital-Based Analysis," is available online and will appear in the February issue of Diabetes Care.