Insulin Treatment Is Associated with Increased Mortality in Patients with COVID-19 and Type 2 Diabetes
Open accessAbstract
COVID-19 caused by SARS-COV-2 infection can lead to multi-organ injuries and significant mortality in severe and critical patients, especially among those individuals with type 2 diabetes (T2D) as a comorbidity. While attenuated mortality was observed with aggressive glucose control, it was unclear whether therapeutic regimens including insulin treatment were beneficial for patients with COVID-19 and T2D. This retrospective study investigated 689 patients with COVID-19 and T2D from a cohort of 3,305 cases from Wuhan, China. Unexpectedly, we found that insulin treatment for patients with COVID-19 and T2D was associated with a significant increase in mortality (27.2% versus 3.5%; adjusted HR, 5.38 [2.75-10.54]). Further analysis showed that insulin treatment was associated with enhanced systemic inflammation and aggravated injuries of vital organs. Therefore, insulin treatment for patients with COVID-19 and T2D should be used with caution.
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Patients with type 2 diabetes and COVID-19 had significantly increased mortality when receiving insulin treatment during hospitalization.
“However, rapamycin has also been observed to enhance expression of IL-6176-178 which is associated with poor COVID-19 outcomes, and patients with type 2 diabetes and COVID-19 had significantly increased mortality rates when receiving insulin treatment during the course of their hospitilization179.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [179]
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References 48 · Cited by 148
Research works printed but not linked: 2
- International Diabetes Federation IDF Diabetes Atlas Ninth Edition 2019 International Diabetes Federation
- National Health Commission of the People’s Republic of China Diagnosis and treatment of COVID-19 (trial version 7) http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml 2020 PMC7491549 32965276
- Authors
- Yu, B., Li, C., Sun, Y., & Wang, D. W.
- Affiliations
- Tongji Hospital (CN)
- Wuhan University (CN)
- Corresponding author
- Wang, Dao Wen
- Venue
- Cell Metabolism
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 33
- Issue
- 1
- Pages
- 65-77.e2
- ISSN
- 1550-4131 (ISSN-L)
- PMC
- PMC7682421
- OpenAlex
- W3109318760
- Cited by
- 148
- References
- 48
- Citations by year
- 2026: 1 · 2025: 16 · 2024: 17 · 2023: 19 · 2022: 42 · 2021: 50 · 2020: 3
- FWCI
- 21.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Cell Metabolism (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Science and Technology of the People's Republic of China
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- COVID-19 pandemic, type 2 diabetes, insulin therapy, mortality, SARS-CoV-2, systemic inflammation, multiple organ injury, glycemic control, comorbidities
- MeSH terms
- COVID-19, COVID-19 Drug Treatment, Aged, Diabetes Mellitus, Type 2, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Retrospective Studies, Cohort Studies, Insulins
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