While diabetes is considered one of the biggest risk factors for severe COVID-19 illness, a new French study has found that at least 1 in every 5 hospitalized COVID patients with diabetes dies within 28 days of admission, according to WebMD.

Dr. Mangala Narasimhan of Northwell Health in New Hyde Park, NY, said, “Diabetic patients are clearly in a very high-risk category and should be among the first groups of people to get the vaccine,” recommending people with diabetes to ensure they have good control over their blood sugar levels with medications and a healthy lifestyle.

Such steps “seem to really make a difference in terms of survival from COVID infection,” said Dr. Narasimhan, who was not a part of the study.

Dialectologists Dr. Bertrand Cariou and Dr. Samy Hadjadj of University Hospital Nantes in France conducted the study.

They released their preliminary findings in May 2020, which showed that “10% of COVID-19 patients with diabetes died within seven days of hospital admission,” according to WebMD.

Now, the newer and updated results are from a larger number of patients (approx. 2,800) treated for COVID-19 at 68 different hospitals across France. Of those, 40% of patients were also experiencing some complications from their diabetes.

The study, published Wednesday in the journal Diabetologia, found that 21% of patients died within the 28 days of hospitalization.

About 50% of patients were discharged from the hospital with a median stay of nine days, 12% were still hospitalized at day 28, and 17% had been transferred from their first hospital to another facility, according to the researchers.

They explained that younger age, using diabetes therapy metformin regularly, and having had symptoms longer prior to hospitalization played a key role in getting discharged from the hospital.

It has also been found that patients who regularly took insulin had a 44% higher risk of death. Poorly controlled or uncontrolled blood sugar at the time of hospitalization was a strong predictor of death and of a lower chance of discharge.

Dr. Barbara Keber of Glen Cove Hospital in Glen Cove, NY, said they show “diabetes is clearly a significant risk factor for both need for ICU/ventilator care in the hospital as well as for death” within a month of admission.

She said it “makes sense” that people with diabetic complications are at higher risk because it creates a “pro-inflammatory state” similar to what is seen in severe COVID-19 illness.

However, Dr. Keber cautioned that death rates might have improved for COVID patients, including those with diabetes, in the past year.

She noted, “This study was done in the first wave of the pandemic, and many of the current treatment regimens and medications that were tried in the early phase have been found to not be beneficial and other treatment regimens have taken their place.”

For example, “the current use of steroids for treatment may play a role in the [improved] prognosis of patients overall and especially for those with diabetes,” Dr. Keber added. The article was originally published Thursday on WebMD.