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World J Diabetes. Sep 15, 2022; 13(9): 729-737
Published online Sep 15, 2022. doi: 10.4239/wjd.v13.i9.729
COVID-19 associated diabetes mellitus: A review
Ajay M Gavkare, Neeta Nanaware, Abhijit S Rayate, Sachin Mumbre, Basavraj S Nagoba
Ajay M Gavkare, Physiology, Maharashtra Institute of Medical Sciences & Research (Medical College), Latur 413531, Maharashtra, India
Neeta Nanaware, Physiology, Vilasrao Deshmukh Government Medical College, Latur 413512, Maharashtra, India
Abhijit S Rayate, Surgery, Maharashtra Institute of Medical Sciences & Research (Medical College), Latur 413531, Maharashtra, India
Sachin Mumbre, Community Medicine, Ashwini Rural Medical College, Solapur 413006, Maharashtra, India
Basavraj S Nagoba, Microbiology, Maharashtra Institute of Medical Sciences & Research (Medical College), Latur 413531, Maharashtra, India
Author contributions: Gavkare AM, Nanaware N and Rayate AS contributed to the literature search, collection of the data and writing the paper; Mumbre S and Nagoba BS contributed to the idea behind the manuscript, writing the paper, modification of content and final approval of the draft.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Basavraj S Nagoba, PhD, Professor, Microbiology, Maharashtra Institute of Medical Sciences & Research (Medical College), Vishwanathpuram, Ambejogai road, Latur 413531, Maharashtra, India. dr_bsnagoba@yahoo.com
Received: March 14, 2022
Peer-review started: March 14, 2022
First decision: May 11, 2022
Revised: May 20, 2022
Accepted: August 17, 2022
Article in press: August 17, 2022
Published online: September 15, 2022
Processing time: 179 Days and 3.4 Hours
Abstract

A significantly higher rate of new-onset diabetes in many coronavirus disease 2019 (COVID-19) patients is a frequently observed phenomenon. The resultant hyperglycemia is known to influence the clinical outcome, thereby increasing the cost of treatment and stay in hospital. This will also affect the post-hospitalization recuperation. It has been observed that new-onset diabetes in COVID-19 patients is associated with considerable increase in morbidity and may be associated with increased mortality in some cases. This mini-review focuses on the possible causes to understand how COVID-19-related diabetes develops, various associated risk factors, and possible mechanism to understand the natural history of the disease process, clinical outcome, associated morbidities and various treatment options in the mana-gement of post COVID-19 diabetes. A literature search was performed in PubMed and other online database using appropriate keywords. A total of 80 articles were found, among which, 53 of the most relevant were evaluated/ analyzed and relevant data were included. The studies show that patients who have had severe acute respiratory syndrome coronavirus 2 infection leading to development of COVID-19 may manifest not only with new-onset diabetes but also worsening of pre-existing diabetes. Cytopathic effect and autoimmune destruction of insulin-secreting pancreatic beta cells, cytokine storm during the active phase of infection causing impaired insulin secretion and resistance, drug-induced hyperglycemia, undetected pre-existing hyperglycemia/diabetic condition, and stress-induced impairment of glucose metabolism are some of the possible potential mechanisms of COVID-19-associated new-onset diabetes mellitus. Many studies published in recent times have found a significantly higher rate of new-onset diabetes mellitus in many COVID-19 patients. Whether it is an inflammatory or immune-mediated response, direct effect of virus or combination of these is unclear. The resultant hyperglycemia is known to influence the clinical outcome and has been associated with considerable increase in morbidity and increased mortality in some cases.

Keywords: Coronavirus disease 2019; Coronavirus disease 2019 associated diabetes; Coronavirus disease 2019 related diabetes; Hyperglycemia in coronavirus disease 2019 patients; New-onset diabetes; Post-coronavirus disease 2019 diabetes

Core Tip: New-onset diabetes is one of the most important complications in patients recovering from coronavirus disease 2019 (COVID-19). This review is focused on different hypotheses that help with understanding of the disease process and suggest management protocols for COVID-19-associated diabetes mellitus.