Koliaki Chrysi, Tentolouris Anastasios, Eleftheriadou Ioanna, Melidonis Andreas, Dimitriadis George, Tentolouris Nikolaos
First Department of Propaedeutic Internal Medicine and Diabetes Center, Medical School, National Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece.
Hellenic Diabetes Association, 11528 Athens, Greece.
J Clin Med. 2020 Jul 18;9(7):2288. doi: 10.3390/jcm9072288.
The management of patients with diabetes mellitus (DM) in the era of the COVID-19 pandemic can be challenging. Even if they are not infected, they are at risk of dysregulated glycemic control due to the restrictive measures which compromise and disrupt healthcare delivery. In the case of infection, people with DM have an increased risk of developing severe complications. The major principles of optimal care for mild outpatient cases include a patient-tailored therapeutic approach, regular glucose monitoring and adherence to medical recommendations regarding lifestyle measures and drug treatment. For critically ill hospitalized patients, tight monitoring of glucose, fluids, electrolytes, pH and blood ketones is of paramount importance to optimize outcomes. All patients with DM do not have an equally increased risk for severity and mortality due to COVID-19. Certain clinical and biological characteristics determine high-risk phenotypes within the DM population and such prognostic markers need to be characterized in future studies. Further research is needed to examine which subgroups of DM patients are expected to benefit the most from specific antiviral, immunomodulatory and other treatment strategies in the context of patient-tailored precision medicine, which emerges as an urgent priority in the era of COVID-19.
在2019冠状病毒病大流行时代，糖尿病患者的管理可能具有挑战性。即使他们未被感染，由于限制措施影响并扰乱了医疗服务的提供，他们也面临血糖控制失调的风险。在感染的情况下，糖尿病患者发生严重并发症的风险会增加。轻度门诊病例的最佳护理主要原则包括针对患者的治疗方法、定期血糖监测以及遵守关于生活方式措施和药物治疗的医疗建议。对于危重症住院患者，严密监测血糖、液体、电解质、pH值和血酮对于优化治疗结果至关重要。并非所有糖尿病患者因2019冠状病毒病而出现重症和死亡的风险都会同等增加。某些临床和生物学特征决定了糖尿病患者群体中的高风险表型，此类预后标志物需要在未来研究中加以明确。在针对患者的精准医学背景下，需要进一步研究以确定哪些糖尿病患者亚组有望从特定的抗病毒、免疫调节和其他治疗策略中获益最多，这在2019冠状病毒病时代已成为当务之急。
