COVID-19 and diabetes mellitus: from pathophysiology to clinical management.
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TLDR
Evidence suggests that insulin and dipeptidyl peptidase 4 inhibitors can be used safely in patients with diabetes mellitus and COVID-19; metformin and sodium–glucose cotransporter 2 inhibitors might need to be withdrawn in patients at high risk of severe disease.Abstract:
Initial studies found increased severity of coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in patients with diabetes mellitus. Furthermore, COVID-19 might also predispose infected individuals to hyperglycaemia. Interacting with other risk factors, hyperglycaemia might modulate immune and inflammatory responses, thus predisposing patients to severe COVID-19 and possible lethal outcomes. Angiotensin-converting enzyme 2 (ACE2), which is part of the renin-angiotensin-aldosterone system (RAAS), is the main entry receptor for SARS-CoV-2; although dipeptidyl peptidase 4 (DPP4) might also act as a binding target. Preliminary data, however, do not suggest a notable effect of glucose-lowering DPP4 inhibitors on SARS-CoV-2 susceptibility. Owing to their pharmacological characteristics, sodium-glucose cotransporter 2 (SGLT2) inhibitors might cause adverse effects in patients with COVID-19 and so cannot be recommended. Currently, insulin should be the main approach to the control of acute glycaemia. Most available evidence does not distinguish between the major types of diabetes mellitus and is related to type 2 diabetes mellitus owing to its high prevalence. However, some limited evidence is now available on type 1 diabetes mellitus and COVID-19. Most of these conclusions are preliminary, and further investigation of the optimal management in patients with diabetes mellitus is warranted.read more
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References
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COVID-19 and diabetes: Can DPP4 inhibition play a role?
TL;DR: This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record.
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Comparison of Hospitalized Patients With ARDS Caused by COVID-19 and H1N1.
Xiao Tang,Rong Hui Du,Rui Wang,Tan Ze Cao,Lu Lu Guan,Cheng Qing Yang,Qi Zhu,Ming Hu,Xu Yan Li,Ying Li,Li Rong Liang,Zhao Hui Tong,Bing Sun,Peng Peng,Huan-Zhong Shi +14 more
TL;DR: The aim of this study was to explore the different clinical presentations between COVID-19 and influenza A (H1N1) pneumonia in patients with ARDS.
Journal ArticleDOI
Fasting blood glucose at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes: a multi-centre retrospective study.
Sufei Wang,Pei Ma,Shujing Zhang,Siwei Song,Zhihui Wang,Yanling Ma,Juanjuan Xu,Feng Wu,Limin Duan,Zhengrong Yin,Huilin Luo,Nian Xiong,Man Xu,Tianshu Zeng,Yang Jin +14 more
TL;DR: Examination of the relationship between fasting blood glucose (FBG) and 28-day mortality in coronavirus disease 2019 (COVID-19) patients not previously diagnosed as having diabetes found that FBG ≥7.0 mmol/l at admission is an independent predictor for 28- day mortality in patients with CO VID-19 without previous diagnosis of diabetes.
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TL;DR: This study uses diabetes registry data to compare the frequency of diabetic ketoacidosis in children and adolescents at time of type 1 diabetes diagnosis in Germany during the first 2 months of the coronavirus disease 2019 pandemic vs the same time period in 2018 and 2019.
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