Diabetes is one of the most commonly reported comorbidities in COVID-19-infected patients. According to current data, diabetic patients do not appear to be at increased risk of contracting SARS-CoV-2 compared to the general population. However, diabetes is a risk factor for developing severe and critical COVID-19 forms, which often require intensive care unit admission and, eventually, invasive mechanical ventilation, which are associated with high mortality rates. The characteristics of COVID-19 diabetic patients and prognostic impact of diabetes on SARS-CoV-2 infection are currently under investigation. Obesity, the main risk factor for incident Type 2 diabetes, appears to be more common in patients with critical COVID-19 forms that require mechanical invasive ventilation. In diabetic patients, COVID-19 is associated with poor glycemic control and acute metabolic complications like ketoacidosis. At present, there are no recommendations in favor of discontinuing antihypertensive medications that interact with the renin-angiotensin-aldosterone system. Owing to the risks of lactic acidosis and ketoacidosis, metformin and SGLT2 inhibitors should be discontinued in patients with severe COVID-19 forms. Finally, we advise a systematic screening for (pre)diabetes in patients with proven SARS-CoV-2 infection.
Diabetes, COVID-19, obesity, hyperglycemia, SARS-CoV-2
What is already known about the topic?
Diabetes is one of the most commonly reported comorbidities in COVID-19-infected patients. Diabetes is not likely to increase the risk of contracting COVID-19. However, it represents a risk factor for developing severe, critical, and fatal COVID-19 forms. Furthermore, COVID-19 is associated with a worsening of glycemic control and a risk for ketoacidosis.
What does this article bring up for us?
Our article summarizes current information available on the clinical presentation and risks associated with COVID-19 in diabetic patients. We also propose several recommendations for the management of COVID-19-infected diabetes patients.