COVID-19 in diabetic patients: Related risks and specifics of management

Abstract

Diabetes is among the most frequently reported comorbidities in patients infected with COVID-19. According to current data, diabetic patients do not appear to be at increased risk of contracting SARS-CoV-2 compared to the general population. On the other hand, diabetes is a risk factor for developing severe and critical forms of COVID-19, the latter requiring admission to an intensive care unit and/or use of invasive mechanical ventilation, with high mortality rates. The characteristics of diabetic patients at risk for developing severe and critical forms of COVID-19, as well as the prognostic impact of diabetes on the course of COVID-19, are under current investigation. Obesity, the main risk factor for incident type 2 diabetes, is more common in patients with critical forms of COVID-19 requiring invasive mechanical ventilation. On the other hand, COVID-19 is usually associated with poor glycemic control and a higher risk of ketoacidosis in diabetic patients. There are currently no recommendations in favour of discontinuing antihypertensive medications that interact with the renin-angiotensin-aldosterone system. Metformin and SGLT2 inhibitors should be discontinued in patients with severe forms of COVID-19 owing to the risks of lactic acidosis and ketoacidosis. Finally, we advise for systematic screening for (pre)diabetes in patients with proven COVID-19 infection.

Level of Awareness among Staff and Students of Academic Institutions towards COVID-19 in India

“…It was also previously described that senior citizens are incredibly vulnerable than the different age groups, and chances of the disease have reported increasing with age up to 14% [12]. Moreover, patients with comorbidities like immune-compromised, cardiac, and diabetic are prone to high mortality with this disease [11,13].…”

Prevention and Management of Type 2 Diabetes and Metabolic Syndrome in the Time of COVID-19: Should We Add a Cup of Coffee?

“…In line with this, it was recently suggested to use metformin as an adjuvant therapy in older, obese, and diabetic patients with COVID-19, who would benefit from this treatment through the reduction of weight, pneumonia, and protrombotic events, partially through the metformin's ability to prevent inflammation and decrease high circulating levels of cytokines, such as interleukin-6 (IL-6) ( 54 ). However, another recent paper cautioned that in patients with severe forms of COVID-19, who are exposed to the risks of lactic acidosis and ketoacidosis, metformin and sodium-glucose co-transporter-2 (SGLT2) inhibitors should be discontinued ( 55 ).…”

Covid-19: The challenges facing endocrinology

“…(zone glomérulée) et possède une activité propre vasoconstrictrice, pro-fibrosante, et pro-inflammatoire. L'ACE2 en convertissant l'angiotensine II [1][2][3][4][5][6][7][8] en angiotensine [1][2][3][4][5][6][7], qui a des propriétés opposées à celles de l'angiotensine II, est donc un régulateur négatif du système rénine-angiotensine. La question légitime soulevée par les auteurs est de savoir si la prescription d'inhibiteur de l'enzyme de conversion [1-10] (IEC) et les bloqueurs du récepteur de type 1 à l'angiotensine (ARAII), très largement utilisés dans le traitement de l'hypertension, pourraient augmenter le risque de développer un syndrome respiratoire aigu sévère en cas d'infection au COVID-19.…”

“…In this issue of the Annals, a current update on the relationships of diabetes, but also obesity, with the risk of contracting Covid-19 or developing a severe form is presented. This didactic article by Laura Orioli et al [8], documented by a literature in full effervescence would be very useful for the informed reader or the general practitioner and will enable him to follow the future recommendations to treat the Covid+ diabetic patients.…”

“…ACE2 converts angiotensin II- [1][2][3][4][5][6][7][8] to angiotensin- [1][2][3][4][5][6][7], which has properties opposite to those of angiotensin II, and is therefore a negative regulator of the RAS. The legitimate question raised by the authors is whether the prescription of converting enzyme inhibitor [1][2][3][4][5][6][7][8][9][10] (ACEi) and angiotensin receptor type 1 blockers (ARAII), very widely used in hypertension treatment, may increase the risk of developing severe acute respiratory syndrome in Covid-19-infected patients. It is convincingly explained why, on the basis of the available evidence, scientific societies do not recommend discontinuation of hypertension treatment by ACEi and ARAIIs in Covid-19+ patients.…”