Interactions between COVID-19 infection and diabetes

The study titled “Interactions between COVID-19 infection and diabetes” by Hassan M. Heshmati delves into the bidirectional relationship between COVID-19 and diabetes, illustrating how each condition can significantly impact the other​​​​.

COVID-19’s Impact on Diabetes:

  1. Lifestyle Changes: The COVID-19 pandemic led to lifestyle alterations such as unhealthy diet and reduced physical activity due to confinement and isolation. These changes can lead to excess adiposity (overweight or obesity), systemic inflammation, and insulin resistance, potentially promoting or aggravating type 2 diabetes​​​​.
  2. Cytokine Storm: COVID-19 can induce a cytokine storm, releasing multiple pro-inflammatory factors like interleukin-6 and tumor necrosis factor-a. This can result in insulin resistance, endothelial dysfunction, and damage to pancreatic islets, potentially promoting or worsening type 1 or type 2 diabetes and related complications​​.
  3. Healthcare Services Disruption: The pandemic caused significant disruptions in diabetes management. Healthcare services had to adapt by minimizing in-person appointments and maximizing remote consultations. This has implications for routine diabetes care and may affect the management and outcomes for diabetic patients​​.

Diabetes’s Impact on COVID-19:

  1. Adipose Tissue: Type 2 diabetes, closely linked to overweight and obesity, increases the number of ACE2 receptors in adipose tissue, making individuals more susceptible to COVID-19 infection. Additionally, excess adiposity may lead to more severe COVID-19 infections and challenges in managing obese patients in intensive care units​​.
  2. Immune System: Diabetes impairs the immune system, heightening the risk of COVID-19 infection and its associated morbidity and mortality. Tight glycemic control and proper COVID-19 vaccination are essential for diabetic patients to mitigate these risks​​.
  3. Complications of Diabetes: The presence of diabetes-related complications like endothelial dysfunction, cardiovascular disease, and nephropathy can lead to poorer outcomes in COVID-19 patients. Some antidiabetic medications may not be suitable in severe COVID-19 cases, and insulin is preferred for hospitalized patients with severe infections​​.

The study concludes by emphasizing the complex and reciprocal interactions between COVID-19 and diabetes. It underscores the importance of recognizing these interactions in clinical practice, particularly for managing diabetes during the pandemic and ensuring optimal care for diabetic patients infected with COVID-19​​.

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