Differences in COVID-19 Outcomes among Patients with Type 1 Diabetes: First vs Later Surges

Mary Pat Gallagher, Saketh Rompicherla, Osagie Ebekozien, Meredith Wilkes, Zoltan Antal, Alexis Jamie Feuer, Nicole Rioles, Nudrat Noor, Liana Gabriel, Grenye O’Malley, Lauren Golden, G. Todd Alonso, Emma Ospelt, Ori Odugbesan, Sarah K. Lyons, Ann Mungmode, Priya Prahalad, Mark Clements, Anna Neyman, Carla Demeterco-BerggrenRobert Rapaport

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Patient outcomes of COVID-19 have improved throughout the pandemic. However, because it is not known whether outcomes of COVID-19 in the type 1 diabetes (T1D) population improved over time, we investigated differences in COVID-19 outcomes for patients with T1D in the United States. Methods: We analyzed data collected via a registry of patients with T1D and COVID-19 from 56 sites between April 2020 and January 2021. We grouped cases into first surge (April 9, 2020, to July 31, 2020, n = 188) and late surge (August 1, 2020, to January 31, 2021, n = 410), and then compared outcomes between both groups using descriptive statistics and logistic regression models. Results: Adverse outcomes were more frequent during the first surge, including diabetic ketoacidosis (32% vs 15%, P< .001), severe hypoglycemia (4% vs 1%, P= .04), and hospitalization (52% vs 22%, P< .001). Patients in the first surge were older (28 [SD,18.8] years vs 18.0 [SD, 11.1] years, P< .001), had higher median hemoglobin A1c levels (9.3 [interquartile range {IQR}, 4.0] vs 8.4 (IQR, 2.8), P< .001), and were more likely to use public insurance (107 [57%] vs 154 [38%], P< .001). The odds of hospitalization for adults in the first surge were 5 times higher compared to the late surge (odds ratio, 5.01; 95% CI, 2.11-12.63). Conclusion: Patients with T1D who presented with COVID-19 during the first surge had a higher proportion of adverse outcomes than those who presented in a later surge.

Original languageEnglish
Pages (from-to)27-31
Number of pages5
JournalJournal of Clinical Outcomes Management
Issue number1
StatePublished - Jan 2022


  • TD1
  • diabetic ketoacidosis
  • hypoglycemia


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