The Management of Diabetes Mellitus in Patients with COVID-19

Abstract

Coronavirus disease 2019 (COVID-19), an infectious disease caused by novel coronavirus SARS-CoV-2, has spread rapidly worldwide and caused more than 110 million confirmed cases and approximately 2.6 million deaths. Diabetes mellitus remains as one of the risk factors of COVID-19 infection. As diabetic patients possess increased inflammatory responses to infection and heightened angiotensin II, it is associated with increased severity, morbidity, and mortality of COVID-19 infection. COVID-19 infection with acute respiratory syndrome itself can be a deteriorating cause for diabetes patients considering that infection may have immediate detrimental effects on the activity of β-cells and precipitate the metabolic complications. The continuation of usual anti-hyperglycemic medications is suitable in most COVID-19 infected patients who are in good general condition with a normal oral intake. However, insulin is mainly recommended for optimal glucose control in hospitalized patients, especially those requiring intensive care. Pharmacists as healthcare professionals should actively participate in educating public about COVID-19 and diabetes management. Pharmacists also play an important role in the management of type 2 diabetes mellitus by giving diabetes self-care education and ensuring sufficient supply of anti-diabetic medications to their patients. This review summarizes the epidemiological trend, pathophysiology, prognosis, risk factors, diagnosis, complications, management and role of pharmacist in diabetes mellitus patient with COVID-19.