RT Journal Article SR Electronic T1 Thresholds of Glycemia and the Outcomes of COVID-19 Complicated With Diabetes: A Retrospective Exploratory Study Using Continuous Glucose Monitoring JF Diabetes Care JO Diabetes Care FD American Diabetes Association SP dc201448 DO 10.2337/dc20-1448 A1 Shen, Yun A1 Fan, Xiaohong A1 Zhang, Lei A1 Wang, Yaxin A1 Li, Cheng A1 Lu, Jingyi A1 Zha, Bingbing A1 Wu, Yueyue A1 Chen, Xiaohua A1 Zhou, Jian A1 Jia, Weiping YR 2021 UL http://care.diabetesjournals.org/content/early/2021/02/11/dc20-1448.abstract AB OBJECTIVE Although elevated glucose levels are reported to be associated with adverse outcomes of coronavirus disease 2019 (COVID-19), the optimal range of glucose in patients with COVID-19 and diabetes remains unknown. This study aimed to investigate the threshold of glycemia and its association with the outcomes of COVID-19.RESEARCH DESIGN AND METHODS Glucose levels were assessed through intermittently scanned continuous glucose monitoring in 35 patients for an average period of 10.2 days. The percentages of time above range (TAR), time below range (TBR), time in range (TIR), and coefficient of variation (CV) were calculated. Composite adverse outcomes were defined as either the need for admission to the intensive care unit, need for mechanical ventilation, or morbidity with critical illness.RESULTS TAR using the threshold of 160–200 mg/dL was significantly associated with composite adverse outcomes after adjustment of covariates. Both TBR (<70 mg/dL) and TIR (70–160 mg/dL), but not mean sensor glucose level, were significantly associated with composite adverse outcomes and prolonged hospitalization. The multivariate-adjusted odds ratios of the CV of sensor glucose across tertiles for composite adverse outcomes of COVID-19 were 1.00, 1.18, and 25.2, respectively.CONCLUSIONS Patients with diabetes and COVID-19 have an increased risk of adverse outcomes with glucose levels >160 mg/dL and <70 mg/dL and a high CV. Therapies that improve these metrics of glycemic control may result in better prognoses for these patients.