High acute-to-chronic glycaemic ratio tied to worse prognosis in T2D patients with COVID-19

Type 2 diabetes (T2D) patients with COVID-19 who have elevated acute-to-chronic (A/C) glycaemic ratio are at increased risk of adverse outcomes, including in-hospital mortality, intensive care unit (ICU) admission, and mechanical ventilation, a study has found.

The study included 91 patients whose blood sugar was measured and average chronic glucose levels estimated at admission. The resulting values were used to calculate the A/C glycaemic ratio.

The primary outcome of a composite of in-hospital mortality, ICU admission, and mechanical ventilation occurred in 35 patients (38.9 percent) over a median observation period of 12 days. Most of these patients were in the third tertile of the A/C glycaemic ratio (60 percent), while 20.7 percent were in the second tertile, and 35.5 percent were in the first tertile.

In an unadjusted Cox proportional hazards model, there was a positive association between the A/C glycaemic ratio and the primary outcome (hazard ratio [HR], 1.57, 95 percent confidence interval [CI], 1.14–2.15; p<0.005). Compared with the second tertile, the third tertile of the A/C glycaemic ratio conferred a threefold increased risk of the primary outcome (HR, 3.39, 95 percent CI, 1.31–8.75; p<0.012) whereas the first tertile had no significant association.

When analysis was controlled for age, sex, comorbidities, inflammatory markers, and corticosteroid therapy, third A/C glycaemic tertile remained a significant predictor of the primary outcome (HR, 3.96, 95 percent CI, 1.35–11.59; p<0.012).

Glucose at admission, estimated chronic glucose levels, and HbA1c tertiles showed no association with the primary outcome.