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COVID-19 and Diabetes.

Awadhesh Kumar Singh1, Kamlesh Khunti2

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Annual Review of Medicine
|August 11, 2021
PubMed
Summary

People with diabetes, including type 1 (T1DM) and type 2 (T2DM), face increased COVID-19 severity and mortality, particularly with poor glycemic control. New-onset diabetes linked to COVID-19 also shows worse outcomes.

Keywords:
COVID-19SARS-CoV-2antidiabetic drugsmortalityseveritytype 1 diabetestype 2 diabetes

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Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Virology

Background:

  • Diabetes mellitus (type 1 and type 2) is a global health concern.
  • Coronavirus disease 2019 (COVID-19) has shown varied prevalence in diabetic populations worldwide.
  • Emerging evidence links diabetes to increased COVID-19 severity and mortality, especially with hyperglycemia.

Purpose of the Study:

  • To review the relationship between diabetes mellitus and COVID-19.
  • To analyze the impact of COVID-19 on glycemic control and diabetes onset.
  • To assess the safety and efficacy of antidiabetic agents in diabetic patients with COVID-19.

Main Methods:

  • Literature review and synthesis of existing evidence.
  • Analysis of reported cases of new-onset diabetes and hyperglycemia in COVID-19 patients.
  • Evaluation of safety data for oral antidiabetic agents in the context of COVID-19.

Main Results:

  • Diabetes, particularly with poor glycemic control, is associated with significantly higher COVID-19 severity and mortality.
  • New-onset hyperglycemia and new-onset diabetes (T1DM and T2DM) are increasingly recognized in COVID-19 patients, correlating with worse outcomes.
  • SARS-CoV-2 does not show conclusive direct tropism on pancreatic β cells.
  • Approved oral antidiabetic agents appear safe for T2DM patients with COVID-19, but no mortality benefit is yet proven.

Conclusions:

  • Diabetes is a significant risk factor for severe COVID-19 outcomes.
  • COVID-19 can trigger new-onset hyperglycemia and diabetes, necessitating careful management.
  • Further research, including large randomized controlled trials, is needed to confirm the mortality benefits of specific antidiabetic drug classes.