Management of Patients with Diabetes Mellitus and COVID-19

Abstract

Objective of the Review: To systematise the information on the incidence of diabetes mellitus (DM) in patients who had the novel coronavirus infection; on the features of virus mechanism activation and pathological cascades in the body; on potential ways to control blood glucose during COVID-19. Key Points. During the novel coronavirus pandemic (COVID-19) associated with high death toll in all countries, specific groups of patients were identified, where the death rate was higher than the mean figures. These groups include DM patients. DM is associated with a high risk of severe coronavirus infection and is the second common comorbidity during COVID-19. DM, degree of its compensation and complications progression impact prognosis, coronavirus infection clinical course and survival. Therefore, effective teamwork of the healthcare professionals and patient is essential. The primary objective of coordination is creation of a clear algorithm of DM management during COVID-19: strict blood glucose monitoring and prompt intensification both of antihyperglycemic therapy and specific ethiopathogenetic management of COVID-19. Conclusion. DM patients require special attention and timely adequate assistance both in outpatient and inpatient settings. Long-term follow-up of DM patients after COVID-19 to minimise the risk of DM complications is also very important. Keywords: COVID-19, diabetes mellitus, novel coronavirus infection.

Long-Term Outcomes of COVID-19 in Hospitalized Type 2 Diabetes Mellitus Patients

“…To stratify the risk of in-hospital death depending on the severity of type 2 diabetes, patients with T2D were divided into two subgroups depending on blood glucose level upon admission to COVD-19-hospital with a cutoff 10 mmol/L, according to the studies of Zhu L. et al (2020) and Andreeva A.V. et al (2021) [1,16]. These previous researchers found that well-controlled blood glucose ranging from 3.9 to 10.0 mmol/L is associated with a significant reduction in composite adverse outcomes and death [1,16].…”

“…et al (2021) [1,16]. These previous researchers found that well-controlled blood glucose ranging from 3.9 to 10.0 mmol/L is associated with a significant reduction in composite adverse outcomes and death [1,16]. In our study, moderate T2D with glucose level <10 mmol/L had a lower hospital mortality rate than severe (p = 0.018), and both T2D groups had higher mortality than control COVID-19 patients (p = 0.033 and p < 0.001 consequently), which supports the correlation of T2D severity and hospital complication rate.…”

“…To stratify the risk of in-hospital death depending on the severity of type 2 diabetes, patients with T2D were divided into two subgroups depending on their blood glucose levels upon admission to COVD-19 hospital: >10 mmol/L (n = 172) and ≤10 mmol/L (n = 209). The use of blood glucose levels for a subgroup analysis was based on the findings of other researchers showing that well-controlled blood glucose with maintenance of glycemic variability between 3.9 and 10.0 mmol/L is associated with a significant reduction in composite adverse outcomes and death [1,16]. In each subgroup, the hospital mortality rate was determined and then compared with the matched (balanced) control group (n = 381).…”