According to the researchers, having high blood sugar can put patients at risk for more severe illness if they contract COVID-19. The reverse also appears to be true: patients with COVID-19 also are at risk for high blood sugar levels, even if they do not have diabetes.
“Based on current evidence, it’s fair to say that the COVID-19 virus, particularly in its most severe forms, leads to much higher blood glucose levels,” study senior author Rodica Pop-Busui, MD, PhD, tells Verywell. Pop-Busui adds that having high blood glucose levels can also lead to worse outcomes for patients with COVID-19.
If left uncontrolled, the inflammation from COVID-19—often called a “cytokine storm”—can cause complications when coupled with inflammation caused by hyperglycemia. It also increases the likelihood of needing mechanical ventilation.
Michigan Medicine Introduces Hyperglycemia Management Teams
The researchers at Michigan Medicine designed a personalized, targeted clinical algorithm—a set of guidelines that helps healthcare providers make decisions—to help frontline healthcare workers without adding to their already heavy workload.
Hyperglycemia is typically defined as a blood sugar level of at least 180 mg/dl or greater when measured one to two hours after eating. However, the defined range varies among health organizations. Diabetes mellitus (type 1, type 2, and gestational) is the most common cause.
To put the guidelines into practice, the researchers launched several hyperglycemia management teams that were tasked with:
Checking patients’ glucose values through venous and arterial blood specimens rather than bedside glucose checks (because it’s more convenient)Creating timely insulin dose adjustments multiple times a dayReducing the number of glucose checks for most patients to every six hours
Not only did the algorithm lower patients’ glucose levels to an acceptable target range (generally 150-180 mg/dL), it also lessened the burden on frontline healthcare workers.
“We developed this early in the course of the pandemic, and we have continued to adapt and improve it based on lessons learned daily on the frontlines,” Pop-Busui says. “Others have started to use variations of this algorithm as well.”
COVID-19 Can Trigger Hyperglycemia
The Michigan Medicine researchers also found that some of the COVID-19 patients who had been referred to them for treatment developed high blood sugar levels even though they did not have diabetes.
“The severe inflammatory reaction triggers insulin resistance and high blood sugar even in people who may not have had known diabetes, but could have been in a prediabetic state," Pop-Busui says.
A recent study published in the Journal of Medical Virology corroborates this idea, showing that out of 184 patients hospitalized with COVID-19, about 24% of patients were prediabetic.
However, factors beyond diabetes and prediabetes can contribute to high blood sugar.
“[Patients with hyperglycemia] may also simply have stress hyperglycemia, which can occur from the stress of illness," Roma Gianchandani, MD, another author of the Michigan Medicine study, tells Verywell,
Regardless of whether patients have prediabetes, diabetes, or stress hyperglycemia, Pop-Busui says their high blood sugar levels need immediate and sustained treatment.
Risks of Untreated Hyperglycemia
Romy Block, MD, an endocrinologist and co-founder of Vous Vitamin, tells Verywell that long-term, high blood sugars can directly injure blood vessels. Several health problems can result from this damage, including:
Eye problems (including blindness) Heart disease (which can lead to a heart attack or stroke) Kidney damage (which may require dialysis or a kidney transplant)
“In many medical conditions, tightly controlled sugars can decrease the duration of illness and decrease the [number of] days spent in the hospital," Block says.
Treatment for hyperglycemia usually includes the administration of insulin—either given intravenously (directly into your vein) or under the skin—to bring down high blood sugar levels.
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.
