BEIJING: Patients with COVID-19 who have elevated blood sugar levels without a previous diagnosis of diabetes may be at a high risk of death and an increased risk of severe complications from the infectious disease, a new study says.

According to the scientists, including those from the Tongji Medical College in China, earlier studies had established high blood sugar as associated with an increased risk of mortality and poor outcomes in COVID-19 patients.

However, they said direct correlation between fasting blood glucose (FBG) level at admission to hospital, and clinical outcomes of COVID-19 patients - without diagnosed diabetes - has not been well established.

In the new study, published in the journal Diabetologia, the researchers examined the association between FBG on admission, and the 28-day mortality of COVID-19 patients without previously diagnosed diabetes in two hospitals in China.

The study assessed data from all consecutive COVID-19 patients with a known outcome at 28-days and FBG measurement at admission from 24 January 2020 to 10 February 2020 in two hospitals based in Wuhan, China.

"Blood sugar testing and control should be recommended to all COVID-19 patients even if they do not have pre-existing diabetes, as most COVID-19 patients are prone to glucose metabolic disorders," they wrote in the study.

Myths & Facts About HypertensionHypertension is the most common and preventable risk factor for heart attacks, heart failure, stroke, kidney disease, and blockage of leg arteries causing pain and gangrene.While it is important to follow a healthy lifestyle, one must educate oneself to control hypertension.One can keep blood pressure (BP) under control with certain changes like eating a healthy diet (fruits/vegetables), working out daily, taking up a weight loss programme, quitting smoking, managing stress with yoga/meditation, and following up on medications and doctor's appointment regularly.From lowering sodium intake to reducing alcohol intake, Dr Nikesh D Jain, Consultant Cardiologist at Jaslok Hospital and Research Centre, shares facts and myths about hypertension.

Hypertension May Not Have Symptoms Hypertension is known as the 'silent killer'. More than 50% hypertension patients do not show any signs or symptoms for many years, and continue to damage blood vessels of important organs in the body. Some patients may experience symptoms like headache, palpitations, chest pain and breathlessness due to hypertension.As soon as an individual turns 18, he/she should ensure checking blood pressure. There is an increasing prevalence of hypertension in younger age group, and is expected to increase further due to lifestyle changes.

Ditch The Table Salt Salt restriction is the most important and effective way to control BP. Daily salt intake should not exceed 4-6 gram/day. Restricting salt means cutting down on intake of Sodium (Na). Apart from the regular table salt, we end up consuming a lot of sodium (approximately 75%) hidden in processed foods like sauce, packaged foods, chips, and junk food. While buying prepared or packaged foods, always look for Sodium (Na) content, and avoid high intake sodium-rich food items.Kosher salt and table salt are the same, and both contain 40% sodium.

Hypertension Is Hereditary Have a strong family history of hypertension puts you at a greater risk of developing the condition at an early age. However, healthy lifestyle changes have helped patients in delaying the onset of hypertension, and even preventing it in some cases.

How Alcohol Affects Blood Pressure Alcohol, when consumed in excess, causes hypertension, stroke, heart failure, irregular heartbeats, high cholesterol, cancer, and even accidents.Alcohol intake should be restricted to two standard drinks per day for men and one drink daily for women. One standard drink equals 14 grams of pure alcohol - which is found in 340 grams of beer, over 110 grams of wine and more than 40 grams of distilled spirits.

They said a total of 605 COVID-19 patients were enrolled in the study, including 114 who died in hospital.

According to the study, the median age of participants was 59 years and 322 were men.

A total of 208 individuals had one or more underlying conditions, but were not diagnosed with diabetes, the scientists said, adding that high blood pressure was the most common co-morbidity.

The researchers said almost one third of the patients fell into the highest category of FBG on admission, which they said would result in a diagnosis of type 2 diabetes if found consistently.

The study noted that a further 17 per cent were in the range that would be considered pre-diabetic, while more than half were in the 'normal' FBG range.

Based on the findings, the researchers said patients in the highest FBG group were 2.3 times more likely to die than those in the lowest.

They said men were 75 per cent more likely to die than women, and that patients with higher CRB65 scores were also at higher risk of death.

"This study shows, for the first time, that elevated FBG at admission is independently associated with increased 28-day mortality and percentages of in-hospital complications in COVID-19 patients without previous diagnosis of diabetes," the scientists noted in the study.

According to the scientists, COVID-19 patients might suffer from high blood sugar brought about by other conditions.

Diabetes is a silent killer that comes unannounced. In most cases, the patients don't find out until it causes long-term damage. Here are some warning signs you should watch out for.

"Patients with conditions not related to diabetes, such as severe sepsis, systemic inflammatory response syndrome (SIRS) and traumatic brain injury tend to have abnormally high blood sugar," the researchers wrote in the study.

Citing the limitations of the study, the scientists said the findings were based on a retrospective analysis of patient data.

They said the study did not analyse levels of the molecule glycated haemoglobin (HbA1c) which is a long-term blood sugar control indicator that helps distinguish patients with poor long-term blood sugar control from those with stress hyperglycaemia.

The researchers added that they did not have sufficient data to study the effect of glucose-lowering treatment such as insulin on the outcome of the patients.

However, they believe acute hyperglycaemia is more important than long-term blood glucose control in predicting the clinical outcomes of hospitalised COVID-19 patients.

The authors suggest that possible mechanisms for this increased mortality include high blood glucose-induced changes in blood clotting, worsening of the function of the walls of blood vessels, and overproduction of inflammatory immune system molecules.

They said measuring fasting blood glucose levels can facilitate the assessment of prognosis and early intervention to help improve the overall outcomes in COVID-19 treatment.

For The Healthy YouAs fancy as it sounds, the idea of boosting immunity, has proven to be difficult to materialise in reality. For years, researchers from across the world have been struggling to figure out the accurate formula to achieve a good immune system. Until the formula is known, it is recommended to adopt a healthy lifestyle for an enhanced immune function, and to keep the body intact and healthy.Making healthy lifestyle changes in terms of diet, exercise and managing stress, in addition to other factors, can go a long way in helping the immune system get the boost it requires. On International Immunology Day, Chennai-based clinical nutritionist, lactation consultant and diabetes educator - Ramya Ramachandran - shares five tips that can give your life a healthy spin.

Opt For A Balanced DietA balanced diet with the right amount of nutrients can do wonders in boosting a persons immunity, and keeping you away from diseases.Ginger, garlic, star anise, omega-3 fats, flax seeds are some foods that have antiviral and anti-inflamma
tory properties. These can be included in your meals daily. Its also important to focus on micronutrients which have a major impact on health.To add the required amount of micronutrients to any diet, one can look at home fortification as an alternative. In this method, a commercially available product is conveniently utilised on a daily basis to prevent nutrition deficiencies. Power mixes of rice and flour avaiable in the market is one such example of food fortification, which increases the micronutrient value of home-cooked meals.

Quit SmokingThis is one of the basic requirements. Smoking is a big NO for the overall wellbeing of the body as it negatively impacts on both adaptive and innate immunity. It slowly kills the natural effectiveness of the immune systems defences. If you are a regular smoker, it is advisable to quit it as soon as possible. One can also adopt alternatives like nicotine patches as it can helps to quit smoking and are relatively less harmful.

Rest Your Mind And Soul With MeditationChronic stress is responsible for releasing hormone cortisol, which can ruin the overall immune response of the body. Meditation goes a long way in keeping stress in check. Various mobile-based apps can help one to remain peaceful and mindful throughout the day with various features. Other healthy strategies to deal with stress may include yoga and pranayama.

Getting A Good Night's SleepMost of us underestimate the power and importance of adequate sound and refreshing sleep. Lack of proper sleep can activate the inflammatory immune response, which can reduce reactivity to vaccines, further leading to the release of excess stress hormones. It will ultimately weaken the immune system.A minimum of 7-8 hours of regular sleep is a must to maintain a healthy circadian rhythm, and help the bodys T-Cells (also known as immune cells) to kill the pathogens. A night of good sleep also helps in burning calories.

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High blood sugar can be deadly for Covid patients, even if they don't have diabetes - Economic Times