Diabetes Metab J.  2020 Dec;44(6):897-907. 10.4093/dmj.2020.0199.

Does Diabetes Increase the Risk of Contracting COVID-19? A Population-Based Study in Korea

• Chun SY
• Kim DW
• Lee SA
• Lee SJ
• Chang JH
• Choi YJ
• Kim SW
• Song SO

• KMID: 2513053
• DOI: http://doi.org/10.4093/dmj.2020.0199

Abstract

Background
This study aimed to determine the infection risk of coronavirus disease 2019 (COVID-19) in patients with diabetes (according to treatment method).
Methods
Claimed subjects to the Korean National Health Insurance claims database diagnosed with COVID-19 were included. Ten thousand sixty-nine patients with COVID-19 between January 28 and April 5, 2020, were included. Stratified random sampling of 1:5 was used to select the control group of COVID-19 patients. In total 50,587 subjects were selected as the control group. After deleting the missing values, 60,656 subjects were included.
Results
Adjusted odds ratio (OR) indicated that diabetic insulin users had a higher risk of COVID-19 than subjects without diabetes (OR, 1.25; 95% confidence interval [CI], 1.03 to 1.53; P=0.0278). In the subgroup analysis, infection risk was higher among diabetes male insulin users (OR, 1.42; 95% CI, 1.07 to 1.89), those between 40 and 59 years (OR, 1.66; 95% CI, 1.13 to 2.44). The infection risk was higher in diabetic insulin users with 2 to 4 years of morbidity (OR, 1.744; 95% CI, 1.003 to 3.044).
Conclusion
Some diabetic patients with certain conditions would be associated with a higher risk of acquiring COVID-19, highlighting their need for special attention. Efforts are warranted to ensure that diabetic patients have minimal exposure to the virus. It is important to establish proactive care and screening tests for diabetic patients suspected with COVID-19 for timely disease diagnosis and management.

Keyword

COVID-19; Diabetes mellitus; Incidence

Figure

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  Fig. 1 Study flow diagram detailing participants. COVID-19, coronavirus disease 2019.

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  Fig. 2 Infection risk of coronavirus disease 2019 in diabetes with their specific conditions compared to matched control subjects without diabetes. DM, diabetes mellitus.

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  Fig. 3 Infection risk of coronavirus disease 2019 (COVID-19) according to infection route in diabetes compared to matched control subjects without diabetes. DM, diabetes mellitus; OHA, oral hypoglycemic agent.

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