{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T11:42:58Z","timestamp":1778154178837,"version":"3.51.4"},"reference-count":37,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T00:00:00Z","timestamp":1706140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This comprehensive retrospective study assesses COVID-19 outcomes in type 1 (T1D) and type 2 diabetes (T2D) patients across three years, focusing on how these outcomes varied with the evolving pandemic and changes in diabetes management. The study aims to determine if COVID-19 outcomes, including severity, intensive care unit (ICU) admission rates, duration of hospitalization, and mortality, are significantly different between these diabetes subtypes. Materials and Methods: The study analyzed data from patients admitted to the Victor Babes Hospital for Infectious Diseases and Pulmonology with confirmed COVID-19 and pre-existing diabetes, from the years 2020, 2021, and 2022. Results: Among 486 patients (200 without diabetes, 62 with T1D, 224 with T2D), T2D patients showed notably higher severity, with 33.5% experiencing severe cases, compared to 25.8% in T1D. Mortality rates were 11.6% in T2D and 8.1% in T1D. T2D patients had longer hospital stays (11.6 \u00b1 7.0 days) compared to T1D (9.1 \u00b1 5.8 days) and were more likely to require ICU admission (OR: 2.24) and mechanical ventilation (OR: 2.46). Hyperglycemia at admission was significantly higher in the diabetes groups, particularly in T2D (178.3 \u00b1 34.7 mg\/dL) compared to T1D (164.8 \u00b1 39.6 mg\/dL). Conclusions: The study reveals a discernible difference in COVID-19 outcomes between T1D and T2D, with T2D patients having longer hospital admissions, mechanical ventilation necessities, and mortality risks.<\/jats:p>","DOI":"10.3390\/medicina60020210","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T10:32:38Z","timestamp":1706178758000},"page":"210","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative Analysis of COVID-19 Outcomes in Type 1 and Type 2 Diabetes: A Three-Year Retrospective Study"],"prefix":"10.3390","volume":"60","author":[{"given":"Flavius","family":"Cioca","sequence":"first","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romulus","family":"Timar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Division of Diabetes, Nutrition and Metabolic Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flavia","family":"Ignuta","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1824-2628","authenticated-orcid":false,"given":"Adrian","family":"Vlad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Division of Diabetes, Nutrition and Metabolic Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-4315","authenticated-orcid":false,"given":"Felix","family":"Bratosin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8236-2205","authenticated-orcid":false,"given":"Ovidiu","family":"Rosca","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adelina Maria","family":"Jianu","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Embryology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Rosca","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susa","family":"Septimiu-Radu","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia-Roxana","family":"Burtic","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Department II, Discipline of Medical Communication, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariadna Petronela","family":"Fildan","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Faculty of Medicine, \u201cOvidius\u201d University of Constanta, 900470 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sorina Maria Denisa","family":"Laitin","sequence":"additional","affiliation":[{"name":"Discipline of Epidemiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"850","DOI":"10.4239\/wjd.v6.i6.850","article-title":"Diabetes mellitus: The epidemic of the century","volume":"6","author":"Kharroubi","year":"2015","journal-title":"World J. Diabetes"},{"key":"ref_2","unstructured":"Magliano, D.J., and Boyko, E.J. (2023, October 25). IDF Diabetes Atlas 10th Edition Scientific Committee, IDF Diabetes Atlas [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK581934\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1186\/s12939-023-01870-1","article-title":"The World Health Organization COVID-19 surveillance database","volume":"22","author":"Allan","year":"2023","journal-title":"Int. J. Equity Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1145138","DOI":"10.3389\/fpubh.2023.1145138","article-title":"A global analysis of COVID-19 infection fatality rate and its associated factors during the Delta and Omicron variant periods: An ecological study","volume":"11","author":"Nguyen","year":"2023","journal-title":"Front. Public Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2938","DOI":"10.2337\/dc20-1506","article-title":"Diabetes as a Risk Factor for Poor Early Outcomes in Patients Hospitalized With COVID-19","volume":"43","author":"Seiglie","year":"2020","journal-title":"Diabetes Care"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"974540","DOI":"10.3389\/fendo.2022.974540","article-title":"COVID-19 and diabetes\u2014Two giants colliding: From pathophysiology to management","volume":"13","author":"Pelle","year":"2022","journal-title":"Front. Endocrinol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1016\/j.numecd.2020.05.014","article-title":"Diabetes as a risk factor for greater COVID-19 severity and in-hospital death: A meta-analysis of observational studies","volume":"30","author":"Mantovani","year":"2020","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s00125-022-05833-z","article-title":"Diabetes and the COVID-19 pandemic","volume":"66","author":"Khunti","year":"2023","journal-title":"Diabetologia"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1136\/postgradmedj-2015-133281","article-title":"Pathophysiology of type 1 and type 2 diabetes mellitus: A 90-year perspective","volume":"92","author":"Zaccardi","year":"2016","journal-title":"Postgrad. Med. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"H403","DOI":"10.1152\/ajpheart.00204.2022","article-title":"Mechanisms of COVID-19 pathogenesis in diabetes","volume":"323","author":"Narasimhulu","year":"2022","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Bedoya, J.P.P., Mu\u00f1oz, A.M., Barengo, N.C., and Valencia, P.A.D. (2022). Type 1 and type 2 diabetes mellitus: Clinical outcomes due to COVID-19. Protocol of a systematic literature review. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0271851"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"380","DOI":"10.4239\/wjd.v6.i3.380","article-title":"Type 1 diabetes: A predictable disease","volume":"6","author":"Simmons","year":"2015","journal-title":"World J. Diabetes"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"756548","DOI":"10.3389\/fimmu.2021.756548","article-title":"Partners in Crime: Beta-Cells and Autoimmune Responses Complicit in Type 1 Diabetes Pathogenesis","volume":"12","author":"Toren","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3611","DOI":"10.2147\/DMSO.S275898","article-title":"Obesity, Insulin Resistance, and Type 2 Diabetes: Associations and Therapeutic Implications","volume":"13","author":"Wondmkun","year":"2020","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"269","DOI":"10.5001\/omj.2012.68","article-title":"Type 2 diabetes mellitus: A review of current trends","volume":"27","author":"Olokoba","year":"2012","journal-title":"Oman Med. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/s12020-022-02985-1","article-title":"The impact of lockdown caused by the COVID-19 pandemic on glycemic control in patients with diabetes","volume":"76","author":"Sutkowska","year":"2022","journal-title":"Endocrine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/S2213-8587(22)00278-9","article-title":"The impact of the COVID-19 pandemic on diabetes services: Planning for a global recovery","volume":"10","author":"Khunti","year":"2022","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1038\/s41574-020-00435-4","article-title":"COVID-19 and diabetes mellitus: From pathophysiology to clinical management","volume":"17","author":"Lim","year":"2021","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2021). Standards of Medical Care in Diabetes\u20142021 Abridged for Primary Care Providers. Clin. Diabetes, 39, 14\u201343.","DOI":"10.2337\/cd21-as01"},{"key":"ref_20","unstructured":"Cascella, M., Rajnik, M., Aleem, A., Dulebohn, S.C., and Di Napoli, R. (2023, October 25). Features, Evaluation, and Treatment of Coronavirus (COVID-19) [Updated 2023 Aug 18], StatPearls [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK554776\/."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1159\/000521288","article-title":"Charlson Comorbidity Index: A Critical Review of Clinimetric Properties","volume":"91","author":"Charlson","year":"2022","journal-title":"Psychother. Psychosom."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s43168-022-00116-y","article-title":"Criteria and potential predictors of severity in patients with COVID-19","volume":"16","author":"Zayed","year":"2022","journal-title":"Egypt. J. Bronchol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"20191","DOI":"10.1038\/s41598-022-24185-7","article-title":"Association of COVID-19 with diabetes: A systematic review and meta-analysis","volume":"12","author":"Ssentongo","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_24","first-page":"444","article-title":"Diabetes is associated with increased mortality and disease severity in hospitalized patients with COVID-19","volume":"20","author":"Tabrizi","year":"2021","journal-title":"EXCLI J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e000649","DOI":"10.20945\/2359-3997000000649","article-title":"Is elevated blood glucose at admission associated with poor outcomes in hospitalized COVID-19 patients?","volume":"67","author":"Barbosa","year":"2023","journal-title":"Arch. Endocrinol. Metab."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"591982","DOI":"10.3389\/fpubh.2021.591982","article-title":"Factors Behind the Higher COVID-19 Risk in Diabetes: A Critical Review","volume":"9","author":"Beshbishy","year":"2021","journal-title":"Front. Public Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"102512","DOI":"10.1016\/j.dsx.2022.102512","article-title":"Comparison of COVID-19 outcomes in patients with Type 1 and Type 2 diabetes: A systematic review and meta-analysis","volume":"16","author":"Shafiee","year":"2022","journal-title":"Diabetes Metab. Syndr. Clin. Res. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"570","DOI":"10.2337\/dc22-1760","article-title":"Severe COVID-19 Infection in Type 1 and Type 2 Diabetes During the First Three Waves in Sweden","volume":"46","author":"Edqvist","year":"2023","journal-title":"Diabetes Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1111\/j.1365-2656.2008.01390.x","article-title":"A working guide to boosted regression trees","volume":"77","author":"Elith","year":"2008","journal-title":"J. Anim. Ecol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.clnesp.2022.07.016","article-title":"Body mass index and clinical outcome of severe COVID-19 patients with acute hypoxic respiratory failure: Unravelling the \u201cobesity paradox\u201d phenomenon","volume":"51","author":"Jennings","year":"2022","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/S2213-8587(20)30271-0","article-title":"Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: A population-based cohort study","volume":"8","author":"Holman","year":"2020","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/S2213-8587(20)30405-8","article-title":"Risks of and risk factors for COVID-19 disease in people with diabetes: A cohort study of the total population of Scotland","volume":"9","author":"McGurnaghan","year":"2021","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1210\/clinem\/dgab668","article-title":"Age and Hospitalization Risk in People With Type 1 Diabetes and COVID-19: Data From the T1D Exchange Surveillance Study","volume":"107","author":"Ebekozien","year":"2022","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e14430","DOI":"10.1111\/dme.14430","article-title":"Sustained type 1 diabetes self-management: Specifying the behaviours involved and their influences","volume":"38","author":"Hamilton","year":"2021","journal-title":"Diabet. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"8327","DOI":"10.12998\/wjcc.v9.i28.8327","article-title":"Diabetes mellitus and COVID-19: Understanding the association in light of current evidence","volume":"9","author":"Sen","year":"2021","journal-title":"World J. Clin. Cases"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1001\/jamainternmed.2021.3047","article-title":"Diabetes Care and Glycemic Control During the COVID-19 Pandemic in the United States","volume":"181","author":"Patel","year":"2021","journal-title":"JAMA Intern. Med."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Atwah, B., Iqbal, M.S., Kabrah, S., Kabrah, A., Alghamdi, S., Tabassum, A., Baghdadi, M.A., and Alzahrani, H. (2023). Susceptibility of Diabetic Patients to COVID-19 Infections: Clinico-Hematological and Complications Analysis. Vaccines, 11.","DOI":"10.3390\/vaccines11030561"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/2\/210\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:49:22Z","timestamp":1760104162000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/2\/210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,25]]},"references-count":37,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["medicina60020210"],"URL":"https:\/\/doi.org\/10.3390\/medicina60020210","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,25]]}}}