Diabetes in COVID-19 pandemic-prevalence, patient characteristics and
adverse outcomes.
Abstract
Abstract Background: Current literature on COVID-19 pandemic has
identified diabetes as a common comorbidity in patients affected.
However, the evidence that diabetes increases the risk of infection,
effect of diabetes on outcomes and characteristics of patients at risk
is not clear. Objectives: To explore the prevalence of diabetes in
COVID-19 pandemic, effect of diabetes on clinical outcomes and to
characterise the patients with diabetes affected by COVID-19. Methods: A
literature review of articles published in English language and reported
outcomes on prevalence and effect of diabetes on outcomes and patients
characteristics. Results: The prevalence of diabetes in COVID-19
patients appears similar to that in the general population. The evidence
of diabetes increasing the risk of severe infection and adverse outcomes
is substantial. The progression of the disease into acute respiratory
distress syndrome, the requirement for intensive care admission or
mechanical ventilation and mortality all have been increased by the
presence of diabetes. Patients with diabetes at risk of COVID-19 appear
to be obese, of older age, have uncontrolled glycaemia and have
coexisting comorbidities especially cardiovascular disease and
hypertension. Tight glycaemic control on admission to hospital using
insulin infusion has shown some beneficial effects however, the role of
hypoglycaemic medications in the management of these patients is not yet
clear. Conclusion: High risk group should be identified and prioritised
in future vaccination programmes. Future research is required to
optimise management of patients with diabetes and develop new ways to
manage them via technological developments such as telecare.