University of California, School of Medicine, San Diego, CA, USA.
Family Medicine Residency Program, Abington-Jefferson Health, Abington, PA, USA.
Postgrad Med. 2021 Nov;133(8):912-919. doi: 10.1080/00325481.2021.1978704. Epub 2021 Oct 4.
Uncontrolled diabetes and/or hyperglycemia is associated with severe COVID-19 disease and increased mortality. It is now known that poor glucose control hospital admission can be associated with a high risk of in-hospital death. By achieving and maintaining glycemic control, primary care physicians (PCPs) play a critical role in limiting this potentially devastating outcome. Further, despite the hope that mass vaccination will help control the pandemic, genetic variants of the virus are causing surges in some countries. As such, PCPs will treat an increasing number of patients with diabetes who have symptoms of post-COVID-19 infection, or even have new-onset type 2 diabetes as a result of COVID-19 infection. However, much of the literature published focuses on the effects of COVID-19 in hospitalized patients, with few publications providing information and advice to those caring for people with diabetes in the primary care setting. This manuscript reviews the current knowledge of the risk and outcomes of individuals with diabetes who are infected with COVID-19 and provides information for PCPs on the importance of glucose control, appropriate treatment, and use of telemedicine and online prescription delivery systems to limit the potentially devastating effects of COVID-19 in people with hyperglycemia.
未控制的糖尿病和/或高血糖与严重的 COVID-19 疾病和死亡率增加有关。现在已知,入院时血糖控制不佳与住院死亡的高风险相关。初级保健医生(PCP)通过实现和维持血糖控制,在限制这种潜在破坏性结果方面发挥着关键作用。此外,尽管人们希望大规模疫苗接种将有助于控制大流行,但病毒的遗传变异正在导致一些国家的病例激增。因此,PCP 将治疗越来越多患有 COVID-19 感染后症状的糖尿病患者,甚至由于 COVID-19 感染而新诊断为 2 型糖尿病。然而,发表的大部分文献都集中在 COVID-19 对住院患者的影响上,很少有出版物为在初级保健环境中照顾糖尿病患者的人提供信息和建议。本文综述了感染 COVID-19 的糖尿病患者的风险和结局的现有知识,并为 PCP 提供了关于血糖控制、适当治疗以及使用远程医疗和在线处方配送系统的重要性的信息,以限制高血糖患者 COVID-19 的潜在破坏性影响。