Considerations for management of patients with diabetes mellitus and acute COVID-19

Efterpi Mougakou; Maria Kyziroglou; Alexandra Tsankof; Evangelos Cholongitas; Konstantinos Tziomalos

doi:10.4239/wjd.v13.i10.802

Considerations for management of patients with diabetes mellitus and acute COVID-19

World J Diabetes. 2022 Oct 15;13(10):802-808. doi: 10.4239/wjd.v13.i10.802.

Authors

Efterpi Mougakou¹, Maria Kyziroglou², Alexandra Tsankof², Evangelos Cholongitas¹, Konstantinos Tziomalos³

Affiliations

¹ First Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens 11527, Greece.
² First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki 54636, Greece.
³ First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki 54636, Greece. ktziomalos@yahoo.com.

Abstract

Diabetes mellitus (DM) is an independent risk factor for admission to intensive care unit and death in patients with coronavirus disease 2019 (COVID-19). On the other hand, medications used in the management of COVID-19 are potentially associated with increases in blood glucose levels and a higher incidence of infections. Accordingly, care of patients with DM and acute COVID-19 requires careful consideration of both diseases. Hyperglycemia and hypoglycemia are associated with adverse outcomes and therefore frequent measurement of blood glucose levels and a basal-bolus insulin regimen are required in most patients. Regarding the management of COVID-19, dexamethasone increases blood glucose levels and might also increase the risk for infections. On the other hand, limited data suggest that antiviral and immunomodulatory agents used in COVID-19 are not strongly associated with higher incidence of infections in this population. As knowledge evolves in this field, optimization of the management of both DM and COVID-19 will hopefully improve the outcome of these patients.

Keywords: Antidiabetic agents; COVID-19; Dexamethasone; Diabetes mellitus; Insulin; Remdesivir; Tocilizumab.

Publication types

Editorial