IDF21-0420 Gender differences in admission A1C in patients with Covid 19 in a low resource healthcare setting in South India

ABSTRACT

Background: Covid-19 and its association with comorbidities especially diabetes has been a global public health challenge. While more men have developed Covid 19, there is limited data on gender differences in glycemic status on admission need to be understood. Aim: To study the gender differences on admission HbA1c in patients hospitalized with Covid-19 and diabetes. Method: All patients admitted to Voluntary Health Services (VHS) with confirmed COVID-19 from May 2020 - May 2021 were included. Diabetes was determined using patients’ past history (diagnosed) or was newly diagnosed if the haemoglobin A1C (HbA1c) level at admission was ≥6.5%. Based on the HbA1c level, the patients were divided into five groups. Group 1 Those below 7%, Group 27–8%, Group 3 8.1–10%, Group 4 10.1–12%, Group 5 above 12%. Patients with HbA1c more than 8 were categorised as having poorly controlled diabetes. The data was retrieved from our institution's medical records and recorded in excel files for further statistical analysis. Results: Of 497 patients who had Covid with diabetes, 342 patients with admission A1c were included for the analysis. Out of 342, 120 (35.1%) were women and 222 (64.9%) were men respectively. The results: Women with HbA1c below 7% n = 22 (22.2%), between 7–12% n = 21(17.1%), above 12% n = 15 (12.8%). Men with A1c value below 7% n = 61 (26.8%), between 7–8% n = 54 (24.5%), 8.1–10% n = 55 (25.0%), 10.1–12% n = 32 (14.5%), above 12% n = 20 (9.1%). This study has revealed that women have poorer baseline glycemic control than men on admission. (See Table 1) Discussion: The gender difference in patients with Covid 19 and DM is not well documented. With this present study, we observed that women have poorly controlled diabetes than men in all subgroups with A1c > 8. This study shows the gender centric impact of the pandemic and given the socioeconomic impact the pandemic is likely to have on the long-term care of women with diabetes, there is an urgent need to create effective communication, policies and interventions to promote optimal care in this vulnerable group.