IRCCS MultiMedica, Milan, Italy.
J Diabetes Complications. 2021 Jul;35(7):107927. doi: 10.1016/j.jdiacomp.2021.107927. Epub 2021 Apr 17.
Evidence suggests that diabetes is one the most relevant comorbidity in affecting the prognosis of COVID-19. Albeit there are no specific trials nor subgroup analysis showing the effect of COVID-19 therapies in patients with diabetes, selected features of this disease and the side effects associated with certain drugs require a proper knowledge to optimize the pharmacological therapy of patients with diabetes and COVID-19. While chronic anti-hypertensive and glucose-lowering therapies should not be discontinued nor preferred for preventive purposes, the low-grade pro-inflammatory, the thrombosis-prone status of diabetes, the role of acute hyperglycaemia in promoting adverse outcomes in patients admitted to ICU, and the observed increased mortality in patients with poor long-term glycaemic control delineate a delicate balance in case of severe forms of COVID-19. Here, we briefly summarized some of the key pharmacological issues linked to the management of patients with diabetes and COVID-19, in order to provide indications to minimize the deleterious effects of the concomitant presentation of these diseases and to use the existing pharmacological options in an appropriate manner.
有证据表明，糖尿病是影响 COVID-19 预后的最相关合并症之一。尽管没有专门的试验或亚组分析显示 COVID-19 疗法对糖尿病患者的影响，但该疾病的某些特征以及某些药物的副作用需要有适当的知识，以优化糖尿病和 COVID-19 患者的药物治疗。虽然慢性抗高血压和降血糖治疗不应因预防目的而中断或首选，但糖尿病的低度炎症、易血栓形成状态、急性高血糖在促进 ICU 患者不良结局中的作用，以及观察到的长期血糖控制不佳患者的死亡率增加，描绘了 COVID-19 严重形式下的微妙平衡。在这里，我们简要总结了与糖尿病和 COVID-19 患者管理相关的一些关键药物问题，以便提供一些指示，以尽量减少这些疾病同时存在的有害影响，并以适当的方式使用现有的药物选择。
