COVID-19 and diabetes mellitus: management of patients during the pandemic
Coronavirus disease 2019 (COVID-19) is a potentially severe acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). People with diabetes mellitus (DM) are at increased risk of serious illness from COVID-19. DM and uncontrolled glycemia were reported as significant predictors of severity and deaths in patients infected with different viruses, including the 2009 pandemic influenza A (H1N1), SARS-CoV and MERS-CoV. In the current SARS-CoV-2 pandemic, some studies did not find a clear association between DM and disease severity. However, other reports from China and Italy showed that older patients with chronic diseases, including DM, were at higher risk for severe COVID-19 and mortality. Among COVID-19 mortality cases in Wuhan, China, major associated comorbidities include DM (42.3 %), hypertension (53.8 %), previous heart disease (19.2 %) and cerebral infarction (15.4 %). Also, mortality strongly increased with the presence of DM (7.3 %) and other comorbidities like cardiovascular disease (10.5 %), chronic respiratory disease, hypertension and cancer, each at 6 %. According to several studies, the prevalence of DM in people infected with the virus is about the same as in the general population, even slightly lower. A meta-analysis of 12 studies describing data from 2,108 Chinese patients with COVID-19 reported a diabetes prevalence of 10.3 %, which was similar to the national prevalence of 10.9 % reported in 2013. Patients with DM are advised to follow general guidance on risk reduction and also specific to DM. All current recommendations of healthcare organizations and scientific communities emphasise the importance of good glycemic control during the COVID-19 pandemic as it may help in reducing the risk of infection and severity.
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