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A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
Diabetes and COVID19: a bidirectional relationship
Ranjit Unnikrishnan1, Anoop Misra2,3,4
1Department of Diabetology, Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, Chennai, India. drranjit@drmohans.com.
Insights
Diabetes does not increase COVID-19 infection risk, but hyperglycemia worsens outcomes. COVID-19 can cause new diabetes or worsen existing cases, impacting patient management.
Area of Science:
- Endocrinology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic highlighted the impact of comorbidities like diabetes on disease outcomes.
- Hyperglycemia, regardless of cause, is linked to severe COVID-19, including respiratory distress, ICU admission, and mortality.
Purpose of the Study:
- To examine the relationship between diabetes, hyperglycemia, and COVID-19 outcomes.
- To understand how COVID-19 affects glucose metabolism and diabetes management.
- To review the implications of public health measures on diabetes care during the pandemic.
Main Methods:
- Review of existing literature on COVID-19 and diabetes.
- Analysis of clinical data linking hyperglycemia to COVID-19 severity.
- Assessment of viral impact on pancreatic function and metabolic control.
- Evaluation of treatment strategies for diabetic patients with COVID-19.
Main Results:
- Diabetes itself does not increase COVID-19 infection risk.
- Hyperglycemia is a significant predictor of worse COVID-19 outcomes.
- COVID-19 can trigger new-onset diabetes and exacerbate pre-existing diabetes through direct viral effects, inflammatory responses, and medication side effects.
- Pandemic-related restrictions can negatively affect diabetes self-management and access to care.
Conclusions:
- Effective management of hyperglycemia is crucial for improving COVID-19 outcomes in diabetic patients.
- COVID-19 poses a dual threat to individuals with diabetes, affecting both infection risk and metabolic control.
- Adaptations in diabetes care, including preferred use of insulin in severe cases, are necessary during the pandemic.
Abstract:
The advent and rapid spread of the coronavirus disease-2019 (COVID19) pandemic across the world has focused attention on the relationship of commonly occurring comorbidities such as diabetes on the course and outcomes of this infection. While diabetes does not seem to be associated with an increased risk of COVID19 infection per se, it has been clearly demonstrated that the presence of hyperglycemia of any degree predisposes to worse outcomes, such as more severe respiratory involvement, ICU admissions, need for mechanical ventilation and mortality. Further, COVID19 infection has been associated with the development of new-onset hyperglycemia and diabetes, and worsening of glycemic control in pre-existing diabetes, due to direct pancreatic damage by the virus, body's stress response to infection (including cytokine storm) and use of diabetogenic drugs such as corticosteroids in the treatment of severe COVID19. In addition, public health measures taken to flatten the pandemic curve (such as lockdowns) can also adversely impact persons with diabetes by limiting their access to clinical care, healthy diet, and opportunities to exercise. Most antidiabetic medications can continue to be used in patients with mild COVID19 but switching over to insulin is preferred in severe disease.
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