New Onset of Diabetes Mellitus and Associated Factors among COVID-19 Patients in COVID-19 Care Centers, Addis Ababa, Ethiopia 2022

Abstract

Introduction. New onset of diabetes mellitus was noted as the commonest comorbidity in the COVID-19 pandemic, which contributed to a worse prognosis. Existing evidence showed that new-onset diabetes is associated with increased mortality compared to nondiabetic and known diabetic patients in the COVID-19 era. SARS-CoV-2 virus can worsen existing diabetes; at the same time, it can trigger new-onset diabetes that eventually worsens patient outcomes. Thus, this study is aimed at determining the prevalence and factors associated with new onset of diabetes mellitus among COVID-19 patients. Methods. Institution-based retrospective cross-sectional study design was conducted by reviewing 244 patient’s records in the Addis Ababa COVID-19 care center. Descriptive statistics and binary logistic regression were used. During bivariate analysis, variables with p ≤ 0.25 were transferred into multivariate analysis. Adjusted odds ratios to determine the strength and presence of the association with a 95% confidence interval and p value ≤ 0.05 were considered, respectively. Results. The mean age of the study participants was 53.2 years with ( SD = 13.35 ). The study findings showed that 31.1% (CI: 25.4-37.4) of COVID-19 patients had new onset of diabetes mellitus; of those, 11.8% had type 1 and 88.2% had type 2 diabetes. Being male ( aOR = 2.9 ; 95% CI: 1.2, 7.1), family history of hypertension ( aOR = 3.7 ; 95% CI: 1.3, 10.5), obesity ( aOR = 3.1 ; 95% CI: 1.01, 8.9), having pulmonary embolism ( aOR = 0.2 ; 95% CI: 0.06, 0.04), and hyperkalemia ( aOR = 9.3 ; 95% CI: 1.8, 47.3) showed statistically significant association with new onset of diabetes mellitus. Conclusion. A significant proportion of COVID-19 patients had been diagnosed with new onset of diabetes mellitus, and new-onset type 2 diabetes mellitus is the most common diabetes mellitus type. Being male, obesity, having a pulmonary embolism, family history of hypertension, and hyperkalemia were independently associated with new onset of diabetes mellitus among COVID-19 patients. Therefore, focused interventions need to be strengthened towards the identified factors.

Impact of COVID-19 on diabetes mellitus outcomes and care in sub-Saharan Africa: A scoping review

“…For every 5-year age interval, being male, insulin treatment and HbA1c ≥7.0% were independently associated with higher odds for both COVID-19-related mortality [14,16,18,33] and hospitalisation [16]. On the other hand, new-onset DM, defined as DM diagnosed in hospitalised COVID-19 patients with prior normoglycaemia, was associated with age over 41 years, male gender and urban residence [50,52].…”

Diabetes mellitus in sub-saharan Africa during the COVID-19 pandemic: A scoping review

“…The DM incidence rate of 13.7/1,000 person-days observation was reported [ 41 ], with a reported median duration from admission to DM occurrence of 11 (IQR 7,13) days [ 41 ]. The proportion of new-onset DM among COVID-19 cases [ 12 , 41 , 43 , 44 ] ranged from 7.3% [ 44 ] to 31.1% (95% CI: 25.4, 37.4) [ 43 ], with 88% of cases manifesting as type 2 DM [ 43 ]. Predictors of new-onset DM in COVID-19 cases were age over 41 years (adjusted Hazard Ration, HR = 2.54, 95% CI: 1.15, 5.57) [ 41 ], being male (adjusted Odds Ratio, OR = 2.9, 95% CI:1.2,7.1) [ 43 ] and urban residence (adjusted HR = 2.49, 95% CI: 1.12, 5.52) [ 41 ].…”

“…The proportion of new-onset DM among COVID-19 cases [ 12 , 41 , 43 , 44 ] ranged from 7.3% [ 44 ] to 31.1% (95% CI: 25.4, 37.4) [ 43 ], with 88% of cases manifesting as type 2 DM [ 43 ]. Predictors of new-onset DM in COVID-19 cases were age over 41 years (adjusted Hazard Ration, HR = 2.54, 95% CI: 1.15, 5.57) [ 41 ], being male (adjusted Odds Ratio, OR = 2.9, 95% CI:1.2,7.1) [ 43 ] and urban residence (adjusted HR = 2.49, 95% CI: 1.12, 5.52) [ 41 ]. The evidence did not specify predictors for different types of DM or indicate specific incidence statistics for different waves of COVID-19 infection.…”

Combining bioinformatics and machine learning algorithms to identify and analyze shared biomarkers and pathways in COVID-19 convalescence and diabetes mellitus

“…COVID-19 continues to have a high worldwide prevalence, and a growing body of evidence indicates it can lead to pathophysiological changes in glucose metabolism. New-onset diabetes is the most common COVID-19 comorbidity, and these patients often experience a dramatic deterioration and poor prognosis ( 31 ). Therefore, identification of the genes and pathways that are altered after COVID-19 convalescence is essential for understanding the molecular basis of DM in these patients.…”