Narrative review on clinical considerations for patients with diabetes and COVID-19: more questions than answers.

Katsiki, Niki; Gómez-Huelgas, Ricardo; Mikhailidis, Dimitri P; Pérez-Martínez, Pablo

Diabetes, obesity and hypertension are common comorbidities associated with increased severity and mortality rates from Corona Virus Disease (COVID)-19 [Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)]. In this narrative review (using the PubMed database), we discuss epidemiological data and pathophysiological links between diabetes and COVID-19. The potential effects of glycaemic control on the prevalence of COVID-19, and vice versa, are also reviewed, as well as the role of telemedicine and diabetes self-management in the post-COVID-19 era. Finally, we comment on the possible impact of certain antidiabetic drugs on COVID-19 prevention and management. Diabetes has been linked to COVID-19 morbidity and mortality, although further research is needed to elucidate this association. In the meantime, physicians should be aware of the potential rise in the prevalence of diabetes, its severity and complications and focus on achieving optimal diabetes prevention and management. Telemedicine and diabetes self-management may help towards this direction. Dipeptidyl-peptidase 4 (DPP4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose transporter 2 (SGLT2) inhibitors may affect viral entry and infection, and thus COVID-19 outcomes, as shown in observational studies. The results of ongoing randomized clinical trials will shed more light on this field.