Department of Geriatric Medicine, Rotherham General Hospital, Rotherham, UK.
Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Droitwich Spa, UK.
Int J Clin Pract. 2021 Jul;75(7):e14112. doi: 10.1111/ijcp.14112. Epub 2021 Mar 14.
Current literature on COVID-19 pandemic has identified diabetes as a common comorbidity in patients affected. However, the evidence that diabetes increases the risk of infection, effect of diabetes on outcomes and characteristics of patients at risk is not clear.
To explore the prevalence of diabetes in COVID-19 pandemic, effect of diabetes on clinical outcomes and to characterise the patients with diabetes affected by COVID-19.
A literature review of articles published in English language and reported outcomes on prevalence and effect of diabetes on outcomes and patients' characteristics.
The prevalence of diabetes in COVID-19 patients appears similar to that in the general population. The evidence of diabetes increasing the risk of severe infection and adverse outcomes is substantial. The progression of the disease into acute respiratory distress syndrome, the requirement for intensive care admission or mechanical ventilation and mortality all have been increased by the presence of diabetes. Patients with diabetes at risk of COVID-19 appear to be obese, of older age, have uncontrolled glycaemia and have coexisting comorbidities especially cardiovascular disease and hypertension. Tight glycaemic control on admission to hospital using insulin infusion has shown some beneficial effects; however, the role of hypoglycaemic medications in the management of these patients is not yet clear.
High risk group should be identified and prioritised in future vaccination programmes. Future research is required to optimise management of patients with diabetes and develop new ways to manage them via technological developments such as telecare.
目前关于 COVID-19 大流行的文献已经确定糖尿病是受影响患者的常见合并症。然而，糖尿病是否会增加感染风险、对结局的影响以及具有风险的患者的特征尚不清楚。
探讨 COVID-19 大流行中糖尿病的患病率、糖尿病对临床结局的影响，并对患有 COVID-19 的糖尿病患者的特征进行描述。
对发表在英文文献中的关于糖尿病患病率以及糖尿病对结局和患者特征影响的文章进行文献回顾。
COVID-19 患者中糖尿病的患病率似乎与普通人群相似。有大量证据表明糖尿病会增加严重感染和不良结局的风险。疾病进展为急性呼吸窘迫综合征、需要入住重症监护病房或接受机械通气以及死亡率均因糖尿病而增加。有感染 COVID-19 风险的糖尿病患者似乎肥胖、年龄较大、血糖控制不佳且伴有并存的合并症，特别是心血管疾病和高血压。入院时使用胰岛素输注进行严格的血糖控制显示出一些有益的效果；然而，低血糖药物在这些患者管理中的作用尚不清楚。
高危人群应在未来的疫苗接种计划中得到识别和优先考虑。需要开展未来的研究以优化糖尿病患者的管理，并通过远程医疗等技术发展找到管理他们的新方法。
