Insulin resistance in COVID-19 and diabetes

Nalini Govender; Olive P Khaliq; Jagidesa Moodley; Thajasvarie Naicker

doi:10.1016/j.pcd.2021.04.004

Insulin resistance in COVID-19 and diabetes

Prim Care Diabetes. 2021 Aug;15(4):629-634. doi: 10.1016/j.pcd.2021.04.004. Epub 2021 Apr 8.

Authors

Nalini Govender¹, Olive P Khaliq², Jagidesa Moodley², Thajasvarie Naicker³

Affiliations

¹ Dept of Basic Medical Sciences, Durban University of Technology, Durban, South Africa. Electronic address: nalinip@dut.ac.za.
² Women's Health and HIV Research Group, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
³ Optics and Imaging Centre, Doris Duke Medical Research Institute, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Abstract

Background: The epidemiology of COVID-19 and its association with cardiometabolic disorders is poorly understood. This is a narrative review that investigates the effects of COVID-19 infection on insulin resistance in patients with diabetes.

Methods: An online search of all published literature was done via PubMed and Google Scholar using the MeSH terms "COVID-19," "SARS-CoV-2," "coronavirus," "insulin resistance," and "diabetes." Only articles that were directly applicable to insulin resistance in COVID-19 and diabetes was reviewed.

Results: Current data shows an increased risk of mortality in patients with diabetes and COVID-19 compared to those without diabetes. COVID-19 triggers insulin resistance in patients, causing chronic metabolic disorders that were non-existent prior to infection.

Conclusion: Patients with diabetes are more susceptible to COVID-19 infection than those without diabetes. ACE2 expression decreases with infection, exaggerating Ang II activity with subsequent insulin resistance development, an exaggerated immune response and severe SARS-COV-2 infection.

Keywords: Angiotensin 2 converting enzyme; Cardiometabolic disorders; Diabetes mellitus; Insulin resistance; SARS-COV-2.

Publication types

Review

MeSH terms

COVID-19 / epidemiology*
COVID-19 / metabolism
COVID-19 / virology
Comorbidity
Diabetes Mellitus / epidemiology*
Diabetes Mellitus / metabolism
Host-Pathogen Interactions
Humans
Insulin Resistance*
Metabolic Syndrome / epidemiology*
Metabolic Syndrome / metabolism
Metabolic Syndrome / virology
Prognosis
Renin-Angiotensin System
Risk Assessment
Risk Factors
SARS-CoV-2 / pathogenicity