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

Evaluation of the impact of stress on glycaemic control in hospitalized type-2 diabetes (T2DM) patients with coronavirus disease (COVID-19). 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. 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). 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.