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Abstract
Introduction: Although blood sugar abnormalities have been reported during COVID-19 pandemic due to ongoing virus-related effects on insulin secretary effects on pancreases and stress and steroids used during management, its long-term effect remains unknown. Real world data on blood sugar abnormalities in follow-up with special emphasis on new onset diabetes mellitus (DM) or unmasking ongoing DM is an issue of concern which remains underestimated and under evaluated in clinical settings.
Methods: Prospective, observational, cohort study conducted between January 2021 to December 2022, included 1,500 COVID-19 patients above 18 years of age irrespective of their disease severity and comorbidity after a valid written consent. All the study cases were followed for six months of discharge from hospital. Protocolled recording of covariates such as blood sugar as fasting, post prandial, and random, HbA1C, blood pressure, anthropometric indices, ECG, blood sugar, lipid profile and uric acid were done at entry point. Documentation of indoor records such as CT Severity scores into mild (score < 8), moderate (score 9-15) and severe (score > 15); inflammatory markers such as IL-6, ferritin, CRP, LDH and D-dimer, and interventions used during hospitalization such as oxygen supplementation and oxygen plus BIPAP/NIV were done as a protocol. Statistical analysis was done by using chi test.
Results: In study of 1,500 post-COVID-19 cases, preexisting DM with aggravation in 10.6% (159/1,500), post-COVID-19 transient hyperglycemia in 42.86% (643/1,500), post-COVID-19 new onset DM in transient group in 21.15% (136/643), post-COVID-19 new onset DM in 10.14% (136/1,341), and no DM or hyperglycemia in 46.53% (698/1,500) cases (p < -0.00001). Significant association was observed between interventions used such as oxygen and oxygen plus BIPAP/NIV requirement, and cases without interventions with blood sugar profile such as new onset DM, preexistent DM with aggravation, post-COVID-19 transient hyperglycemia and no DM or hyperglycemia (p < 0.00001). Significant association was observed in blood sugar level switch from normoglycemic to transient hyperglycemic to DM range during pre- to post-COVID-19 state in follow up (p < 0.00001). Covariates analysis such as age, gender, body mass index observed significant association with cases with new onset DM, preexistent DM with aggravation, post-COVID-19 transient hyperglycemia and no DM (p < 0.00001). Comorbidities such as hypertension and IHD observed significant association with blood sugar profile in study cases in post-COVID-19 setting (p < 0.00001). Inflammatory markers during hospitalization, HRCT severity score and uric acid analysis during follow-up documented significant association with new onset DM, preexistent DM with aggravation, post-COVID-19 transient hyperglycemia and no DM or hyperglycemia during post-COVID-19 follow-up (p < 0.00001).
Conclusion: COVID-19 has been associated with blood sugar abnormalities such as transient hyperglycemia, aggravation of underlying DM as a result of ongoing disease process and treatment options used during management indoor settings. Inflammatory markers during hospitalization, interventions used during indoor period and severity of COVID-19 chest imaging has a positive association with blood sugar abnormalities. Proportionate number of transient hyperglycemia cases have evolved towards new onset DM cases in follow up of post-COVID-19 settings. COVID-19 illness has played a role in unmasking effect on new onset DM.
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Article Type: Original Article
ELECTRON J GEN MED, Volume 23, Issue 1, February 2026, Article No: em708
https://doi.org/10.29333/ejgm/17675
Publication date: 01 Jan 2026
Online publication date: 31 Dec 2025
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