COVID-19 and Diabetes

Abstract

Diabetes mellitus (DM) is one of the most common comorbid conditions in persons with COVID-19 and a risk factor for poor prognosis. The reasons why COVID-19 is more severe in persons with DM are currently unknown although the scarce data available on patients with DM hospitalized because of COVID-19 show that glycemic control is inadequate. The fact that patients with COVID-19 are usually cared for by health professionals with limited experience in the management of diabetes and the need to prevent exposure to the virus may also be obstacles to glycemic control in patients with COVID-19. Effective clinical care should consider various aspects, including screening for the disease in at-risk persons, education, and monitoring of control and complications. We examine the effect of COVID-19 on DM in terms of glycemic control and the restrictions arising from the pandemic and assess management of diabetes and drug therapy in various scenarios, taking into account factors such as physical exercise, diet, blood glucose monitoring, and pharmacological treatment. Specific attention is given to patients who have been admitted to hospital and critically ill patients. Finally, we consider the role of telemedicine in the management of DM patients with COVID-19 during the pandemic and in the future.

Perceptions about the Management of Patients with DM2 and COVID-19 in the Hospital Care Setting

“…Sulfonylureas increase the risk of hypoglycemia and are discouraged in hospitalized patients with severe disease. The use of metformin possesses a certain risk of lactic acidosis in patients with hypoxia and acute disease [ 43 ], and it is consequently contraindicated in patients with respiratory problems and hypoxia. Some authors advise a careful monitoring of kidney disease and also the withdrawal of metformin in dehydrated patients as there is a risk of lactic acidosis [ 41 ], and some others state its contraindication in patients hospitalized due to COVID-19 [ 40 ].…”

Research, adapt, and overcome: Changes in submission rates to endocrinology scientific journals during the COVID-19 pandemic

“…While eye clinics have plenty of elective activity, which was likely postponed many times in lockdowns, enabling the clinician to attend to research activity; endocrinologists are part of the internal medicine realm, and as such were put often in the front-line of treating COVID-19 patients. Moreover, with the rise of telehealth capabilities and implementation, clinical endocrinologists could partially manage established patients such as in the case of diabetes ( 8 , 9 ) and were most likely somewhat occupied by such activity.…”

Potential long-term effects of SARS-CoV-2 infection on the pulmonary vasculature: Multilayered cross-talks in the setting of coinfections and comorbidities

“…Patients with diabetes mellitus (DM) who contract infection with SARS-CoV-2 are at greater risk of developing severe COVID-19 with respiratory failure and in-hospital mortality [ 200 , 201 ]. Not only does COVID-19 put people with DM at-risk for poor prognosis during the acute disease course, but it also may serve as a trigger that accelerates molecular processes that are pathognomonic of vascular diseases, including PH.…”