Poster - #2022SPHU-3 - Keywords: COVID, HBA1C , DIABETES , RECOVERY, INSULIN

"A Pilot study: Impact of COVID-19 recovery on HbA1C."

Geethika Thota, Y Zou, A Santharaman, Dr.Hongxiu Luo, MD
Department of Internal Medicine, Saint Peter’s University Hospital / Rutgers University, New Brunswick,NJ

ABSTRACT:
Introduction Coronavirus disease 2019 (COVID-19) infection is confirmed to worsen type 2 diabetes (DM2) control by significantly increasing HbA1c. Most of the patients required insulin therapy inpatient setting, with higher insulin dose or need to start insulin if not on insulin before COVID19 infections. However, after discharge, the impact of recovery from acute COVID 19 on HbA1c is not clear to the medical society. This impact is very important to guide physicians to properly adjust insulin dose and whole DM2 management plan. Therefore, we conduct a pilot study to look up this impact. Methods A retrospective chart review was performed with patients with Type 2 Diabetes Mellitus and admitted with acute COVID 19 infection during March 2020 and June 2020. They were followed up at our outpatient Adult Health Clinic after being discharged from our hospital. Data were extracted from the electronic medical record (EMR) system. A total of 18 charts were analyzed. Those patients who were not followed up in our clinic were excluded. HbA1C levels were checked every 3 months until one 1year since diagnosis of COVID-19 infection. Results The paired T-test for A1C between hospitalization and the first follow-up visit is performed. The mean difference in A1C is 4.17. The difference is statistically significant, P<0.01. The Mean of HbA1C before discharge and the first follow-up visit are 11.95 and 7.79 indicating the significance of COVID infection on glycemic control. Medications during the management of COVID are also considered. 7 out of the 18 charts reviewed were treated with systemic steroids as standard care. Conclusion While several studies have already documented the impact of COVID19 acute infection on worsening HbA1c control, we would like to highlight the impact of the recovery of acute COVID-19 on glycemic control. Our study has demonstrated that people with diabetes with higher A1C during the time of COVID infection were found to have significant HbA1c improvement as evidenced by the mean difference of 4.17 during follow-up visits. Most of the patients had significantly decreased insulin requirements with adequate glycemic control. For those who did not need insulin before the Covid19 infection, insulin requirements significantly decreased and were eventually discontinued within the first year. We describe this result to highlight the importance to follow up with those COVID19 patients, who are discharged with insulin, more frequently (less than 3 months) to promptly decrease the insulin dose or adjust the Type2 Diabetes management plan to prevent life-threatening hypoglycemic events.