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

• Published in: Frontiers in endocrinology (Lausanne) 2021-06, Vol.12, p.649525
• Main Authors: Landstra, Cyril P, de Koning, Eelco J P
• Format: Article
• Language: English
• Subjects: coronavirus; COVID-19; COVID-19 - diagnosis; COVID-19 - epidemiology; COVID-19 - etiology; COVID-19 - pathology; diabetes; Diabetes Complications - diagnosis; Diabetes Complications - epidemiology; Diabetes Complications - pathology; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diabetes Mellitus - pathology; Diabetes Mellitus - virology; Disease Progression; Endocrinology; Humans; mortality; Pandemics; Prognosis; Risk Factors; SARS-CoV-2; SARS-CoV-2 - physiology; severity; Severity of Illness Index
• ISSN: 1664-2392; 1664-2392
• DOI: 10.3389/fendo.2021.649525

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.