Faculty of Health Sciences, Nord University, Bodø 8049, Norway; Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Brazil; International Diabetes Federation (IDF), 166 Chaussee de La Hulpe, B - 1170 Brussels, Belgium; Diabetes Asian Study Group (DASG), Ambwadi, Ahmedabad 380015, Gujarat, India; Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka 1000, Bangladesh.
Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka 1000, Bangladesh; Institute of Health and Society, Department of Community Medicine and Global Health, University of Oslo (UiO), Oslo 0318, Norway.
Diabetes Res Clin Pract. 2020 Apr;162:108142. doi: 10.1016/j.diabres.2020.108142. Epub 2020 Apr 9.
We aimed to briefly review the general characteristics of the novel coronavirus (SARS-CoV-2) and provide a better understanding of the coronavirus disease (COVID-19) in people with diabetes, and its management.
We searched for articles in PubMed and Google Scholar databases till 02 April 2020, with the following keywords: "SARS-CoV-2", "COVID-19", "infection", "pathogenesis", "incubation period", "transmission", "clinical features", "diagnosis", "treatment", "diabetes", with interposition of the Boolean operator "AND".
The clinical spectrum of COVID-19 is heterogeneous, ranging from mild flu-like symptoms to acute respiratory distress syndrome, multiple organ failure and death. Older age, diabetes and other comorbidities are reported as significant predictors of morbidity and mortality. Chronic inflammation, increased coagulation activity, immune response impairment, and potential direct pancreatic damage by SARS-CoV-2 might be among the underlying mechanisms of the association between diabetes and COVID-19. No conclusive evidence exists to support the discontinuation of angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers or thiazolidinediones because of COVID-19 in people with diabetes. Caution should be taken to potential hypoglycemic events with the use of chloroquine in these subjects. Patient tailored therapeutic strategies, rigorous glucose monitoring and careful consideration of drug interactions might reduce adverse outcomes.
Suggestions are made on the possible pathophysiological mechanisms of the relationship between diabetes and COVID-19, and its management. No definite conclusions can be made based on current limited evidence. Further research regarding this relationship and its clinical management is warranted.
简要回顾新型冠状病毒（SARS-CoV-2）的一般特征，并更好地了解糖尿病患者中的冠状病毒病（COVID-19）及其管理。
我们在 PubMed 和 Google Scholar 数据库中搜索了截至 2020 年 4 月 2 日的文章，使用了以下关键词：“SARS-CoV-2”、“COVID-19”、“感染”、“发病机制”、“潜伏期”、“传播”、“临床特征”、“诊断”、“治疗”、“糖尿病”，并用布尔运算符“AND”隔开。
COVID-19 的临床谱是异质的，从轻度流感样症状到急性呼吸窘迫综合征、多器官衰竭和死亡不等。年龄较大、糖尿病和其他合并症被报道为发病率和死亡率的重要预测因素。慢性炎症、凝血活性增加、免疫反应受损以及 SARS-CoV-2 对胰腺的潜在直接损害可能是糖尿病与 COVID-19 之间关联的潜在机制之一。没有确凿的证据支持因 COVID-19 而停止使用糖尿病患者的血管紧张素转换酶抑制剂（ACEI）、血管紧张素受体阻滞剂或噻唑烷二酮类药物。在这些患者中使用氯喹时应注意潜在的低血糖事件。根据患者的具体情况制定治疗策略、严格监测血糖并仔细考虑药物相互作用可能会降低不良后果的发生风险。
就糖尿病与 COVID-19 之间的可能病理生理机制及其管理提出了建议。根据目前有限的证据，无法得出明确的结论。需要进一步研究这种关系及其临床管理。
