Published online Oct 15, 2022. doi: 10.4239/wjd.v13.i10.802
Peer-review started: March 30, 2022
First decision: May 11, 2022
Revised: May 23, 2022
Accepted: August 17, 2022
Article in press: August 17, 2022
Published online: October 15, 2022
Processing time: 197 Days and 21.3 Hours
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.
Core Tip: Diabetes mellitus is a frequent comorbidity in patients hospitalized with coronavirus disease 2019 and is associated with adverse outcomes. Strict glycemic control using insulin is necessary in most of these patients. Dexamethasone, antiviral agents and immunomodulation are also frequently administered and require vigilance and careful monitoring for adverse effects, particularly infections.