COVID-19 and Diabetes: Understanding the Interrelationship and Risks for a Severe Course

Front Endocrinol (Lausanne). 2021 Jun 17:12:649525. doi: 10.3389/fendo.2021.649525. eCollection 2021.

Abstract

The relationship between COVID-19 and diabetes mellitus is complicated and bidirectional. On the one hand, diabetes mellitus is considered one of the most important risk factors for a severe course of COVID-19. Several factors that are often present in diabetes mellitus are likely to contribute to this risk, such as older age, a proinflammatory and hypercoagulable state, hyperglycemia and underlying comorbidities (hypertension, cardiovascular disease, chronic kidney disease and obesity). On the other hand, a severe COVID-19 infection, and its treatment with steroids, can have a specific negative impact on diabetes itself, leading to worsening of hyperglycemia through increased insulin resistance and reduced β-cell secretory function. Worsening hyperglycemia can, in turn, adversely affect the course of COVID-19. Although more knowledge gradually surfaces as the pandemic progresses, challenges in understanding the interrelationship between COVID-19 and diabetes remain.

Keywords: COVID-19; SARS-CoV-2; comorbidities; coronavirus; diabetes; mortality; severity; treatment.

Publication types

  • Review

MeSH terms

  • COVID-19 / diagnosis
  • COVID-19 / epidemiology
  • COVID-19 / etiology*
  • COVID-19 / pathology*
  • Diabetes Complications / diagnosis
  • Diabetes Complications / epidemiology
  • Diabetes Complications / pathology
  • Diabetes Mellitus* / diagnosis
  • Diabetes Mellitus* / epidemiology
  • Diabetes Mellitus* / pathology
  • Diabetes Mellitus* / virology
  • Disease Progression
  • Humans
  • Pandemics
  • Prognosis
  • Risk Factors
  • SARS-CoV-2 / physiology
  • Severity of Illness Index