What is the relationship between COVID-19 and diabetes mellitus?

Bottom Line:

Diabetes mellitus (DM) can lead to poor outcomes in patients with COVID-19 due to a compromised immune system, inflammation, and use of certain medications (e.g. RAAS antagonists). Conversely, in patients who have diabetes mellitus, a COVID-19 infection can worsen glucose control because of the drugs used to treat the infection (e.g. corticosteroids, lopinavir/ritonavir), as well as cause cell damage in the pancreas, low potassium levels, and insulin resistance.

Reference:

Pal, R. & Bhadada S.K. COVID-19 and diabetes mellitus: An unholy interaction of two pandemics. Diabetes & Metabolic Syndrome: Clinical Research & Reviews (2020). https://doi.org/10.1016/j.dsx.2020.04.049

Date Published:

6 May 2020

Synopsis:

This review examined a number of studies with patients who have diabetes mellitus (DM) and COVID-19. Evidence from China demonstrates that patients with DM have a higher risk of mortality (7.3% in DM vs. 2.3% overall) than patients without DM. So far, research hasn’t shown a difference in outcomes between type 1 DM and type 2 DM in a COVID-19 infection, but it is likely that both types can contribute to worsening outcomes. Using the available evidence, researchers have concluded that COVID-19 in patients with DM can worsen glucose control which negatively impacts the immune system’s response to fight the infection and promotes inflammation. This leads to a vicious cycle that deteriorates the patient’s condition. Physicians also need to consider the role of drugs used to treat COVID-19 on glucose control in these patients because many of these drugs (e.g. corticosteroids, lopinavir-ritonavir) can lead to high glucose levels, and insulin resistance. Given the impact of this infection on DM, patients need to be extra cautious and take all necessary precautions when entering public spaces. Furthermore, patients should aim to have good control of their sugar levels during this time to help boost their immune system’s ability to fight off a potential infection.

Summary by: Brintha Sivajohan