Type 2 Diabetes Mellitus

Intensive care medicine

Endocrinology

Coronavirus disease 2019 (COVID-19)

Infectious disease (medical specialty)

Internal medicine

Epidemiology

Medicine

Pandemic

Disease

Diabetes mellitus

EMERGENCY MEDICINE

Background. Since December 2019, the new coronavirus disease 2019 (COVID-19) has been marching confidently and aggressively across the planet. On March 11, 2020, the World Health Organization has declared COVID-19 a pandemic. Among the risk factors for the development and severe course of COVID-19, there are old age, arterial hypertension, diabetes mellitus, chronic obstructive pulmonary disease, cardiovascular and cerebrovascular diseases. However, recently, based on the epidemiological data obtained, diabetes mellitus is no longer considered a risk factor for infection with SARS-CoV-2, but the presence of concomitant diabetes is associated with a more severe course of COVID-19 and deterioration in treatment outcomes. What is the reason for the complicated course of COVID-19 in patients with diabetes mellitus? The need to answer this question led to the conduction of this study. The purpose was to determine the causes of complicated course of COVID-19 in patients with diabetes mellitus. Material and methods. We searched for publications using the search engines PubMed and Google Scholar by keywords: COVID-19, diabetes mellitus, hyperglycemia, carbohydrate metabolism disorders, complications. Results. The review of the scientific literature considers the main causes and pathogenetic mechanisms of COVID-19 complications in patients with diabetes mellitus. Groups of factors that worsen the course of the diseases have been identified, and it has been proven that current treatment of COVID-19 in patients with diabetes mellitus should take into account all available risk factors and include a multidisciplinary team approach involving specialists in emergency medicine, endocrinology, infectious diseases, respiratory support, nutritional science and rehabilitation. Conclusions. The main causes that worsen the course of COVID-19 in patients with diabetes mellitus are: 1) features of diabetes itself and the interaction of diabetes and COVID-19; 2) the impact of certain drugs used in the treatment of both diseases; 3) shortcomings in the organization of treatment and care of patients. The main factor that is crucial in the management of these patients is the normalization of blood glucose levels and carbohydrate balance, which must be achieved by all possible means.

Main causes of complicated COVID-19 in patients with diabetes mellitus