Management of diabetes patients during the covid-19 epidemic

Authors

  • Miodrag Janić Department of Endocrinology, Diabetes and Metabolic Diseases, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia; Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia https://orcid.org/0000-0001-7073-8922
  • Mojca Lunder Department of Endocrinology, Diabetes and Metabolic Diseases, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia; Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  • Andrej Janež Department of Endocrinology, Diabetes and Metabolic Diseases, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia; Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

DOI:

https://doi.org/10.6016/ZdravVestn.3093

Keywords:

diabetes, covid-19, SARS-CoV-2, antidiabetic drugs, management of diabetes during epidemic

Abstract

The year 2020 will undoubtedly be marked by the coronavirus disease 2019 (covid-19) pandemic, caused by the novel coronavirus SARS-CoV-2. It has been shown that in diabetes patients, covid-19 occurs in a more severe form, with these patients being more prone to the need for mechanical ventilation and having higher mortality rates than non-diabetic patients. In the present article, we describe possible pathophysiological mechanisms that could explain a more severe course of covid-19 in diabetes patients. We also describe the recommendations for use and discontinuation of anti-diabetic drugs during infection, and continue by explaining how to adjust the management of this chronic disease during an epidemic. In conclusion, our own experience in organizing outpatient diabetes clinic during the covid-19 epidemic at the University Medical Centre Ljubljana is described. Covid-19 still carries many unknowns, so it will not surprise us, if we soon realize that the findings described so far, are outdated. Nonetheless, the present recommendations for the treatment of diabetes patients during the epidemic will remain in force and will hopefully help to improve and optimize the treatment of our patients, even after the pandemic.

Downloads

Download data is not yet available.

References

1. Bornstein SR, Rubino F, Khunti K, Mingrone G, Hopkins D, Birkenfeld AL, et al. Practical recommendations for the management of diabetes in patients with COVID-19. Lancet Diabetes Endocrinol. 2020;8(6):546-50.
DOI: 10.1016/S2213-8587(20)30152-2
PMID: 32334646

2. WHO Coronavirus (COVID-19) Dashboard. Geneva: World Health Organization; 2020 [cited 2021 Mar 20]. Available from: https://covid19.who.int/.

3. Gupta R, Ghosh A, Singh AK, Misra A. Clinical considerations for patients with diabetes in times of COVID-19 epidemic. Diabetes Metab Syndr. 2020;14(3):211-2.
DOI: 10.1016/j.dsx.2020.03.002
PMID: 32172175

4. Katulanda P, Dissanayake HA, Ranathunga I, Ratnasamy V, Wijewickrama PS, Yogendranathan N, et al. Prevention and management of COVID-19 among patients with diabetes: an appraisal of the literature. Diabetologia. 2020;63(8):1440-52.
DOI: 10.1007/s00125-020-05164-x
PMID: 32405783

5. Shenoy A, Ismaily M, Bajaj M. Diabetes and covid-19: a global health challenge. BMJ Open Diabetes Res Care. 2020;8(1):e001450.
DOI: 10.1136/bmjdrc-2020-001450
PMID: 32345580

6. Muniyappa R, Gubbi S. COVID-19 pandemic, coronaviruses, and diabetes mellitus. Am J Physiol Endocrinol Metab. 2020;318(5):E736-41.
DOI: 10.1152/ajpendo.00124.2020
PMID: 32228322

7. Guo W, Li M, Dong Y, Zhou H, Zhang Z, Tian C, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev. 2020;36(7):e3319.
DOI: 10.1002/dmrr.3319
PMID: 32233013

8. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42.
DOI: 10.1001/jama.2020.2648
PMID: 32091533

9. Cariou B, Hadjadj S, Wargny M, Pichelin M, Al-Salameh A, Allix I, et al. Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study. Diabetologia. 2020;63(8):1500-15.
DOI: 10.1007/s00125-020-05180-x
PMID: 32472191

10. Wargny M, Gourdy P, Ludwig L, Seret-Bégué D, Bourron O, Darmon P, et al.; CORONADO investigators. Type 1 Diabetes in People Hospitalized for COVID-19: New Insights From the CORONADO Study. Diabetes Care. 2020;43(11):e174-7.
DOI: 10.2337/dc20-1217
PMID: 32847826

11. Barron E, Bakhai C, Kar P, Weaver A, Bradley D, Ismail H, et al. Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study. Lancet Diabetes Endocrinol. 2020;8(10):813-22.
DOI: 10.1016/S2213-8587(20)30272-2
PMID: 32798472

12. Seiglie J, Platt J, Cromer SJ, Bunda B, Foulkes AS, Bassett IV, et al. Diabetes as a Risk Factor for Poor Early Outcomes in Patients Hospitalized With COVID-19. Diabetes Care. 2020;43(12):2938-44.
DOI: 10.2337/dc20-1506
PMID: 32847827

13. Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes Metab Syndr. 2020;14(4):303-10.
DOI: 10.1016/j.dsx.2020.04.004
PMID: 32298981

14. COVID-19 sledilnik. Ljubljana: Luka Renko; 2021 [cited 2021 Jan 20]. Available from: https://covid-19.sledilnik.org/sl/stats.

15. Akash MS, Rehman K, Fiayyaz F, Sabir S, Khurshid M. Diabetes-associated infections: development of antimicrobial resistance and possible treatment strategies. Arch Microbiol. 2020;202(5):953-65.
DOI: 10.1007/s00203-020-01818-x
PMID: 32016521

16. Erener S. Diabetes, infection risk and COVID-19. Mol Metab. 2020;39:101044.
DOI: 10.1016/j.molmet.2020.101044
PMID: 32585364

17. Lim S, Bae JH, Kwon HS, Nauck MA. COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nat Rev Endocrinol. 2021;17(1):11-30.
DOI: 10.1038/s41574-020-00435-4
PMID: 33188364

18. Bindom SM, Lazartigues E. The sweeter side of ACE2: physiological evidence for a role in diabetes. Mol Cell Endocrinol. 2009;302(2):193-202.
DOI: 10.1016/j.mce.2008.09.020
PMID: 18948167

19. Pal R, Bhansali A. COVID-19, diabetes mellitus and ACE2: the conundrum. Diabetes Res Clin Pract. 2020;162:108132.
DOI: 10.1016/j.diabres.2020.108132
PMID: 32234504

20. Smith SM, Boppana A, Traupman JA, Unson E, Maddock DA, Chao K, et al. Impaired glucose metabolism in patients with diabetes, prediabetes, and obesity is associated with severe COVID-19. J Med Virol. 2020;93(1):409-15.
DOI: 10.1002/jmv.26227
PMID: 32589756

21. Pal R, Banerjee M, Yadav U, Bhattacharjee S. Clinical profile and outcomes in COVID-19 patients with diabetic ketoacidosis: A systematic review of literature. Diabetes Metab Syndr. 2020;14(6):1563-9.
DOI: 10.1016/j.dsx.2020.08.015
PMID: 32853901

22. Cariou B, Goronflot T, Rimbert A, Boullu S, Le May C, Moulin P, et al. Routine use of statins and increased mortality related to COVID-19 in inpatients with type 2 diabetes: results from the CORONADO study. Diabetes Metab. 2020;47(2):101202.
DOI: 10.1016/j.diabet.2020.10.001
PMID: 33091555

23. Zhang XJ, Qin JJ, Cheng X, Shen L, Zhao YC, Yuan Y, et al. In-Hospital Use of Statins Is Associated with a Reduced Risk of Mortality among Individuals with COVID-19. Cell Metab. 2020;32(2):176-187.e4.
DOI: 10.1016/j.cmet.2020.06.015
PMID: 32592657

24. Iacobellis G. COVID-19 and diabetes: can DPP4 inhibition play a role? Diabetes Res Clin Pract. 2020;162:108125.
DOI: 10.1016/j.diabres.2020.108125
PMID: 32224164

25. Ceriello A, Stoian AP, Rizzo M. COVID-19 and diabetes management: what should be considered? Diabetes Res Clin Pract. 2020;163:108151.
DOI: 10.1016/j.diabres.2020.108151
PMID: 32305399

26. Katulanda P, Dissanayake HA, Ranathunga I, Ratnasamy V, Wijewickrama PS, Yogendranathan N, et al. Prevention and management of COVID-19 among patients with diabetes: an appraisal of the literature. Diabetologia. 2020;63(8):1440-52.
DOI: 10.1007/s00125-020-05164-x
PMID: 32405783

27. Drucker DJ. Coronavirus Infections and Type 2 Diabetes-Shared Pathways with Therapeutic Implications. Endocr Rev. 2020;41(3):bnaa011.
DOI: 10.1210/endrev/bnaa011
PMID: 32294179

28. Group RC, Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, et al. Dexamethasone in Hospitalized Patients with Covid-19 - Preliminary Report. N Engl J Med. 2020;384(8):693,704.
DOI: 10.1056/NEJMoa20214361
PMID: 32678530

29. Mehta N, Mazer-Amirshahi M, Alkindi N, Pourmand A. Pharmacotherapy in COVID-19; A narrative review for emergency providers. Am J Emerg Med. 2020;38(7):1488-93.
DOI: 10.1016/j.ajem.2020.04.035
PMID: 32336586

30. Alessi J, de Oliveira GB, Schaan BD, Telo GH. Dexamethasone in the era of COVID-19: friend or foe? An essay on the effects of dexamethasone and the potential risks of its inadvertent use in patients with diabetes. Diabetol Metab Syndr. 2020;12(1):80.
DOI: 10.1186/s13098-020-00583-7
PMID: 32922517

31. Ma RC, Holt RI. COVID-19 and diabetes. Diabet Med. 2020;37(5):723-5.
DOI: 10.1111/dme.14300
PMID: 32242990

32. Rogers LC, Lavery LA, Joseph WS, Armstrong DG. All Feet On Deck-The Role of Podiatry During the COVID-19 Pandemic: preventing hospitalizations in an overburdened healthcare system, reducing amputation and death in people with diabetes. J Am Podiatr Med Assoc. 2020:1-11.
DOI: 10.7547/20-051
PMID: 32208983

33. Papanas N, Papachristou S. COVID-19 and Diabetic Foot: Will the Lamp Burn Bright? Int J Low Extrem Wounds. 2020;19(2):111.
DOI: 10.1177/1534734620921382
PMID: 32320324

Published

2021-06-29

Issue

Section

Professional Article

How to Cite

1.
Management of diabetes patients during the covid-19 epidemic. ZdravVestn [Internet]. 2021 Jun. 29 [cited 2024 Oct. 6];90(5-6):322-35. Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/3093

Most read articles by the same author(s)

1 2 > >>