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Uncontrolled Blood Sugar Contributes to COVID-19 Mortality in Type 2 Diabetics

  • Jeff Trinkl, MD
  • Kieran Gallagher, MPH
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Type 2 diabetes has been strongly associated with increased risk of mortality among COVID-19 patients, and our findings support this strong association. In a population of 185,600 COVID-19 positive patients, diabetic patients were 86% more likely to die after controlling for age, sex, and race/ethnicity.

Figure 1. Type 2 diabetics experience a higher COVID-19 mortality rate compared to the general population. Our analysis found that 75% of this increased risk is explained by high blood sugar, while the remaining 25% is the result of other factors.

Some researchers have suggested factors associated with diabetes, such as high blood sugar, high insulin levels, and impaired immune response, are responsible for the increase risk.1 Focusing on high blood sugar, we found that high blood sugar explained 75% of the increased risk of mortality in type 2 diabetics.

33,060 COVID-19 positive patients with type 2 diabetes were studied. A hemoglobin A1c (HbA1c) result was used as a measure of blood glucose control with a value greater than 7% an indicator of uncontrolled blood sugar. An HbA1c was resulted in the past one year for 43% of patients. We used a statistical technique to account for the patients without HbA1c data. This and other methods are addressed in an expanded article.

Data are pooled from 41 healthcare organizations representing 412 hospitals that span 21 states and cover 167 million patients.

1. Ranganath Muniyappa and Sriram Gubbi. COVID-19 pandemic, coronaviruses, and diabetes mellitus. Am J Physiol Endocrinol Metab 2020; 318:E736-E741.


  1. This finding is startling in how much high blood sugar is implicated in serious illness and mortality. It’s so stark that its almost hard to believe. Are there other studies that show similar findings? If so, this ought to be front page news in terms of steps to reduce avoidable deaths.

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