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patients with diabetes mellitus and COVID-19; metformin and sodium–glucose cotransporter 2 inhibitors might need to be withdrawn in patients at high risk of severe disease.Abstract: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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Journal ArticleDOI
Lopinavir/ritonavir combination therapy amongst symptomatic coronavirus disease 2019 patients in india: Protocol for restricted public health emergency use
Tarun Bhatnagar,Manoj V Murhekar,Manish Soneja,Nivedita Gupta,Sidhartha Giri,Naveet Wig,Raman R. Gangakhedkar +6 more
TL;DR: The restricted public health use of lopinavir/ritonavir combination amongst symptomatic COVID-19 patients detected in the country is approved and further evaluation using a randomized control trial design is warranted to guide future therapeutic use of this combination.
Posted ContentDOI
Serology-informed estimates of SARS-COV-2 infection fatality risk in Geneva, Switzerland
Javier Perez-Saez,Javier Perez-Saez,Stephen A. Lauer,Laurent Kaiser,Laurent Kaiser,Simon Regard,Elisabeth Delaporte,Idris Guessous,Idris Guessous,Silvia Stringhini,Silvia Stringhini,Andrew S. Azman,Andrew S. Azman +12 more
TL;DR: This work estimated overall and age-specific IFR for the canton of Geneva, Switzerland using age-stratified daily case and death incidence reports combined with five weekly population-based seroprevalence estimates, and reveals that population-wide estimates of IFR mask great heterogeneity by age and point towards the importance of age-targeted interventions to reduce exposures among those at highest risk of death.
Journal ArticleDOI
Diabetes as a Risk Factor for Poor Early Outcomes in Patients Hospitalized With COVID-19.
Jacqueline A. Seiglie,Jesse M. Platt,Jesse M. Platt,Sara Jane Cromer,Bridget Bunda,Andrea S. Foulkes,Ingrid V. Bassett,John Hsu,James B. Meigs,Aaron Leong,Melissa S. Putman,Melissa S. Putman,Virginia A. Triant,Deborah J. Wexler,Jennifer Manne-Goehler +14 more
TL;DR: Among hospitalized patients with COVID-19, diabetes was associated with poor early outcomes, after adjustment for obesity, and these findings can help inform patient-centered care decision making for people with diabetes at risk for CO VID-19.
Journal ArticleDOI
Type 1 diabetes onset triggered by COVID-19.
TL;DR: There was a short delay between COVID-19 infection and diabetes onset, and it remains to determine if the hyperinflammation/ cytokine storm described with this infection could accelerate the onset of type 1 diabetes in genetically susceptible individuals.
Journal ArticleDOI
Polymorphisms in dipeptidyl peptidase 4 reduce host cell entry of Middle East respiratory syndrome coronavirus.
Hannah Kleine-Weber,Simon Schroeder,Nadine Krüger,Alexander Prokscha,Hassan Y. Naim,Marcel A. Müller,Marcel A. Müller,Christian Drosten,Christian Drosten,Stefan Pöhlmann,Markus Hoffmann +10 more
TL;DR: Collectively, naturally-occurring polymorphisms in DPP4 are identified that negatively impact cellular entry of MERS-CoV and might thus modulate MERS development in infected patients.
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