Episode description

In the first year of the COVID-19 pandemic, a handful of international studies showed that there was increased risk of adverse outcomes in hospitalised patients comorbid for diabetes. Odds ratios for mortality conferred by pre-existing diabetes ranged from 1.5 to 3.6. What this relationship might be in Australia was not known until researchers in Melbourne retrospectively examined electronic medical records from the two waves of COVID-19 in that city.  

The prevalence of diabetes among Melbourne inpatients is around 35% and in 2020 over 70% of all Australia’s case load was in Victoria. This presented an opportunity to observe the relationship between the conditions with substantial statistical power. But while ICU admission and mortality were more common in those with diabetes than those without, neither diabetes nor hyperglycaemia were independently associated with in-hospital mortality. In this podcast the authors speculate as to why there was this deviation from patterns observed internationally. A possible explanation involves the receipt of dexamethasone therapy in patients with hyperglycaemia, which was found by other researchers to be preventative for COVID-19-associated mortality. 

Guests
Associate Professor John Wentworth FRACP (Royal Melbourne Hospital, Walter and Eliza Hall Institute)
Dr Rahul Barmanray FRACP (Royal Melbourne Hospital; the University of Melbourne)
Dr Dev Kevat FRACP (Western Health; Monash University)
Dr Mohammad Ashraful Islam (Goulburn Valley Health) 

Key Reference

• Rahul D Barmanray Diabetes IN hospital – Glucose and Outcomes in the COVID-19 pandemic (DINGO COVID-19): the 2020 Melbourne hospital experience prior to novel variants and vaccinationsInternal Medicine Journal 2021; 53(1)
• Access to IMJ, JPCH and OMJ for RACP members

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