The COVID-19 pandemic has revealed a significant association between SARS-CoV-2 infection and diabetes, whereby individuals with diabetes are more susceptible to severe disease and higher mortality rates. Interestingly, recent findings suggest a reciprocal relationship between COVID-19 and diabetes, wherein COVID-19 may contribute to developing new-onset diabetes and worsen existing metabolic abnormalities. This narrative review aims to shed light on the intricate molecular mechanisms underlying the diabetogenic effects of COVID-19. Specifically, the review explores the potential role of various factors, including direct damage to β-cells, insulin resistance triggered by systemic inflammation, and disturbances in hormonal regulation, aiming to enhance our understanding of the COVID-19 impact on the development and progression of diabetes. By analysing these mechanisms, the aim is to enhance our understanding of the impact of COVID-19 on the development and progression of diabetes. The binding of SARS-CoV-2 to angiotensin-converting enzyme 2 (ACE2) receptors, which are present in key metabolic organs and tissues, may interfere with glucometabolic pathways, leading to hyperglycaemia, and potentially contribute to the development of new disease mechanisms. The virus’s impact on β-cells through direct invasion or systemic inflammation may induce insulin resistance and disrupt glucose homeostasis. Furthermore, glucocorticoids, commonly used to treat COVID-19, may exacerbate hyperglycaemia and insulin resistance, potentially contributing to new-onset diabetes. The long-term effects of COVID-19 on glucose metabolism are still unknown, necessitating further research into the possibility of developing a novel type of diabetes. This article provides a comprehensive overview of the current understanding of the interaction between COVID-19 and diabetes, highlighting potential areas for future research and therapeutic interventions.
Objectives:The main objectives of the research are to examine the incidence of hyperlipoproteinemia in postmenopausal women and to determine the differences in lipid profile considering age, duration of menopause and body mass index in postmenopausal women.Respondents and methods: The research is structured as cross-sectional with historical data. The research used data collected during regular check-ups in primary health care clinics in Osijek Health Center from November 2021 to March 2022. Collected data: demographic data, information on the duration of menopause, body mass, body height, body mass index, values of total, LDL, HDL cholesterol and triglycerides, and data on associated diseases.Results: 98 postmenopausal women were included in the research, of which over 50% had elevated total and LDL cholesterol values, and 39.8% had elevated triglyceride values. Subjects aged 45 to 65 years and subjects with a duration of menopause of 10 or more years had significantly higher values of total and LDL cholesterol while no difference was observed in the lipid profile with regard to the body mass index. Using the SCORE2 table, it was estimated that 65% of the subjects had a very high cardiovascular risk, and only 6% of the subjects achieved the target values of LDL cholesterol in accordance with the cardiovascular risk.Conclusion: There is a very high incidence of hyperlipoproteinemia in postmenopausal women, and the age and duration of menopause have an impact on the poorer achievement of the target values of the lipid profile, while the body mass index showed no impact. Given the high prevalence of subjects with a very high cardiovascular risk (SCORE 2 tables), intensive interventions are needed at all levels of health care, especially at the primary level of health care, which include non-pharmacological and pharmacological methods of treating hyperlipoproteinemia.
(1) Background: The increased risk of developing hypoglycemia and worsening of glycemic stability during exercise is a major cause of concern for patients with type 1 diabetes mellitus (T1DM). (2) Aim: This pilot study aimed to assess glycemic stability and hypoglycemic episodes during and after aerobic versus resistance exercises using a flash glucose monitoring system in patients with T1DM. (3) Participants and Methods: We conducted a randomized crossover prospective study including 14 adult patients with T1DM. Patients were randomized according to the type of exercise (aerobic vs. resistance) with a recovery period of three days between a change of groups. Glucose stability and hypoglycemic episodes were evaluated during and 24 h after the exercise. Growth hormone (GH), cortisol, and lactate levels were determined at rest, 0, 30, and 60 min post-exercise period. (4) Results: The median age of patients was 53 years, with a median HbA1c of 7.1% and a duration of diabetes of 30 years. During both training sessions, there was a drop in glucose levels immediately after the exercise (0′), followed by an increase at 30′ and 60′, although the difference was not statistically significant. However, glucose levels significantly decreased from 60′ to 24 h in the post-exercise period (p = 0.001) for both types of exercise. Glycemic stability was comparable prior to and after exercise for both training sessions. No differences in the number of hypoglycemic episodes, duration of hypoglycemia, and average glucose level in 24 h post-exercise period were observed between groups. Time to hypoglycemia onset was prolonged after the resistance as opposed to aerobic training (13 vs. 8 h, p = NS). There were no nocturnal hypoglycemic episodes (between 0 and 6 a.m.) after the resistance compared to aerobic exercise (4 vs. 0, p = NS). GH and cortisol responses were similar between the two sessions, while lactate levels were significantly more increased after resistance training. (5) Conclusion: Both exercise regimes induced similar blood glucose responses during and immediately following acute exercise.
Lockdown measures to control disease transmission were implemented at the start of the COVID-19 era, worsening the already existing sedentary lifestyle. Reduced physical activity (PA) and unhealthy eating habits have a negative impact on mental health in chronically ill patients, including diabetes patients. Mental illness, on the other hand, encourages a sedentary lifestyle, exacerbating all components of metabolic syndrome. While well-controlled diabetic patients with an HbA1c of less than 7% had a less severe clinical presentation and COVID-19 mortality rates, the favorable effect of PA on immunomodulation and immunoregulation should not be neglected. Given recent data indicating that a sedentary lifestyle is the third independent risk factor for COVID-19 complications and death (after advanced age and organ transplant), including regular PA has never been more vital. Since PA has a major impact on both glycemic control and mental health, implementing structured home-based activity programs could improve glycemic control and psychological well-being, hence positively impacting COVID-19 outcomes.
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