Impact of COVID-19-related Stress on Glycaemic Control in Hospitalized Patients with Type 2 Diabetes Mellitus

Abstract

Background: Evaluation of the impact of stress on glycaemic control in hospitalized type-2 diabetes (T2DM) patients with coronavirus disease (COVID-19).Methods: In this retrospective study conducted at a single centre in Maharashtra from May to July 2020 on hospitalized COVID-19 patients with T2DM who reported having stress of pandemic; they were selected using purposive sampling. DASS-12 stress sub-scale was used to estimate the severity of their stress. Fasting blood glucose (FBG) and post-prandial blood glucose (PPBG) before admission and at the time of discharge were compared.Results: One hundred and ninety-nine patients (mean age 54 years; 61.30% females) were included. Mean±SD FBG before admission was 168.4±30.6 mg/dl which increased to 195.9±28.8 mg/dl at the time of discharge (P<0.001). Also, Mean±SD PPBG before admission was 312±62.3 mg/dl which increased to 351.6±61.9 mg/dl (P<0.001). A total of 73 (36.7%) participants had perceived stress. Moderate and severe/extremely severe stress was found in 44 (27.1%) and 19 (9.6%) patients, respectively. A significant difference was observed in the mean FBG before and during discharge in patients who had no stress and those with moderate stress (P<0.001). There was no difference in FBG in patients with severe/extremely severe stress (P=0.43). Similar observations were seen for PPBG (no stress P<0.001; moderate stress P<0.001; severe/extremely severe stress P=0.06).Conclusion: There was a rise in the glucose level in T2DM patients discharged after COVID-19 treatment. The increase was significant in T2DM without stress and those with moderate stress. In addition to traditional treatment, measures for psychological stress control should also be taken for such patients.

Keywords

• covid-19
• stress
• psychological
• blood glucose
• biological monitoring