COVID-19 and diabetes

Abstract

Almost immediately after the emergence of the SARS-CoV-2 coronavirus, it was observed that people with chronic diseases, including diabetes, presented an increased risk of hospitalization and mortality. Diabetes can increase the risk of COVID-associated mortality by more than six times. The hypothesis of a bidirectional relationship between COVID-19 and diabetes assumes that diabetes is a risk factor for worse outcomes of COVID-19 treatment and that coronavirus infection is a predisposing factor for newly diagnosed diabetes or hyperglycemic emergencies. New diagnoses or exacerbations of existing diabetes are associated with direct damage to the pancreas or the body's response to chronic inflammation, and ACE receptors play a large role in this pathomechanism. Restrictions implemented in many countries have resulted in poorer control and underdiagnosis of diabetes. In this review, we summarize the impact of acute COVID-19 on people with diabetes, discuss how presentation and epidemiology changed during the pandemic, and consider the broader impact of the pandemic on patients and healthcare delivery.