Department of Pharmacy, Bhagwant University, Ajmer, Rajasthan-305004, India.
Department of Pharmacy, Vivek College of Technical Education, Bijnor, Uttar Pradesh-246701, India.
Curr Diabetes Rev. 2023;19(1):e150322202260. doi: 10.2174/1573399818666220315162424.
Diabetes mellitus (DM) and steroid medication, coincided with coronavirus disease 2019 (COVID-19), results in a weakened immune system, allowing some commonly found pathogens to become more harmful. Mucormycosis (black fungus) is a type of opportunistic infection caused by fungi belonging to the Mucorales family. DM is the most prominent risk factor for mucormycosis. Excessive blood sugar and decreased insulin levels lead to diabetic ketoacidosis (DKA), a devastating complication of DM that can be fatal if left untreated.
Diabetic ketoacidosis is more common in type 1 diabetic patients, although it can also be fall in type 2 diabetic patients. DKA occurs when the body lacks enough insulin to allow blood sugar to enter the cells and is used for energy. Instead, the liver breaks down fat for fuel-producing chemicals known as ketones.
When too many ketones are created too quickly, they can reach dangerously high levels in the body. Mucormycosis is a rare but serious infectious disease that requires medication or surgical removal.
The confluence of diabetes and COVID-19 makes managing mucormycosis a serious and dead issue. Although the effectiveness of prophylactic antifungal therapy has yet to be demonstrated, hyperglycemia control appears to be the most important step in managing mucormycosis in DKA patients.
糖尿病(DM)和类固醇药物与 2019 年冠状病毒病(COVID-19)同时发生,导致免疫系统减弱,使一些常见的病原体变得更具危害性。毛霉菌病(黑霉病)是一种由毛霉菌科真菌引起的机会性感染。DM 是毛霉菌病的最显著危险因素。过高的血糖和胰岛素水平下降导致糖尿病酮症酸中毒(DKA),这是 DM 的一种毁灭性并发症,如果不治疗可能致命。
糖尿病酮症酸中毒在 1 型糖尿病患者中更为常见,但也可能发生在 2 型糖尿病患者中。当身体缺乏足够的胰岛素来使血糖进入细胞并用于能量时,就会发生 DKA。相反,肝脏会分解脂肪,产生称为酮的产燃料化学物质。
当产生的酮过多且过快时,它们会在体内达到危险的高水平。毛霉菌病是一种罕见但严重的传染病,需要药物治疗或手术切除。
糖尿病和 COVID-19 的同时存在使得管理毛霉菌病成为一个严重的、致命的问题。虽然预防性抗真菌治疗的有效性尚未得到证实,但控制高血糖似乎是 DKA 患者管理毛霉菌病的最重要步骤。