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About: Diabetes is a risk factor for severity of coronavirus disease 2019 (COVID‐19). Little is known how the COVID‐19 pandemic has disrupted diabetes‐related acute care. We compared hospitalization rates for severe hyperglycemia or hypoglycemia during COVID‐19 outbreak in Hong Kong (study period: 25 January to 24 April 2020) with those during 25 January to 24 April 2019 (inter‐year control), and 25 October 2019 to 24 January 2020 (intra‐year control), using Poisson regression analysis. Hospitalization rates abruptly decreased after the first confirmed local COVID‐19 case on 23 January 2020, by 27% and 23% compared with inter‐year and intra‐year control periods respectively (incidence rate ratio 0.73 and 0.77, p<0.001). Hospitalizations were reduced for severe hyperglycemia and hypoglycemia, but not diabetic ketoacidosis. This significant reduction in hospitalization rates should alert endocrinologists to take proactive measures to optimize glycemic control of individuals with diabetes.

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