Department of Genetics, Stanford University, Stanford, CA
Illumina Artificial Intelligence Laboratory, Illumina Inc., San Diego, CA.
Diabetes. 2021 Dec;70(12):2733-2744. doi: 10.2337/dbi21-0029. Epub 2021 Oct 22.
The coronavirus disease 2019 (COVID-19) global pandemic continues to spread worldwide with approximately 216 million confirmed cases and 4.49 million deaths to date. Intensive efforts are ongoing to combat this disease by suppressing viral transmission, understanding its pathogenesis, developing vaccination strategies, and identifying effective therapeutic targets. Individuals with preexisting diabetes also show higher incidence of COVID-19 illness and poorer prognosis upon infection. Likewise, an increased frequency of diabetes onset and diabetes complications has been reported in patients following COVID-19 diagnosis. COVID-19 may elevate the risk of hyperglycemia and other complications in patients with and without prior diabetes history. It is unclear whether the virus induces type 1 or type 2 diabetes or instead causes a novel atypical form of diabetes. Moreover, it remains unknown if recovering COVID-19 patients exhibit a higher risk of developing new-onset diabetes or its complications going forward. The aim of this review is to summarize what is currently known about the epidemiology and mechanisms of this bidirectional relationship between COVID-19 and diabetes. We highlight major challenges that hinder the study of COVID-19-induced new-onset of diabetes and propose a potential framework for overcoming these obstacles. We also review state-of-the-art wearables and microsampling technologies that can further study diabetes management and progression in new-onset diabetes cases. We conclude by outlining current research initiatives investigating the bidirectional relationship between COVID-19 and diabetes, some with emphasis on wearable technology.
新型冠状病毒病(COVID-19)大流行继续在全球范围内传播,截至目前,已确诊病例约 2.16 亿例,死亡病例 449 万例。目前正在通过抑制病毒传播、了解其发病机制、开发疫苗接种策略和确定有效的治疗靶点等方法来积极抗击该疾病。患有糖尿病等基础疾病的个体在感染 COVID-19 后,其疾病发病率更高,预后更差。同样,在 COVID-19 确诊后,患者发生糖尿病发作和糖尿病并发症的频率也有所增加。COVID-19 可能会使有或无既往糖尿病史的患者出现高血糖和其他并发症的风险升高。目前尚不清楚该病毒是会导致 1 型或 2 型糖尿病,还是会导致一种新型的非典型糖尿病。此外,尚不清楚 COVID-19 康复患者是否会有更高的风险发展为新发糖尿病或其并发症。本文综述了目前已知的 COVID-19 与糖尿病之间这种双向关系的流行病学和发病机制。我们强调了阻碍 COVID-19 诱导新发糖尿病研究的主要挑战,并提出了克服这些障碍的潜在框架。我们还回顾了可进一步研究新发糖尿病患者的糖尿病管理和进展的最新可穿戴设备和微采样技术。最后,我们概述了目前正在研究 COVID-19 与糖尿病之间双向关系的一些研究计划,其中一些研究计划重点关注可穿戴技术。