Department of Clinical Pharmacology and Medicine, College of Medicine, AL-Mustansiriyia University, Baghdad, Iraq.
Department of Pharmacology & Health Research Unit, Medical College, Jouf University, Sakakah, Saudi Arabia.
Curr Mol Pharmacol. 2023;16(4):494-506. doi: 10.2174/1874467215666220908091604.
COVID-19 is caused by the SARS-CoV-2 virus, which has afflicted more than 245.37 million individuals worldwide and resulted in more than 4.9 million deaths as of today, with a mortality rate of 2.1%. Diabetes mellitus (DM) and its secondary complications are the major serious global health concerns today due to its growth rate, and it is the fastest-growing non-communicable disease. According to International Diabetes Federation (IDF) data, one out of 11 adults is diabetic, and the projection says that the figure will reach 642 million by 2040 globally. The occurrence of DM and its secondary complications is also associated with the severity of COVID-19 and high mortality. People with DM have a weakened immune system owing to innate immunity defects affecting phagocytosis, neutrophil chemotaxis, and cellmediated immunity; however, the high prevalence of diabetes in serious cases of COVID-19 may reflect the higher prevalence of type 2 DM (T2DM) in older people. Moreover, DM is linked to cardiovascular illness in older people, which could underlie the correlation between COVID-19 and fatal outcomes. SARS-CoV-2 infects via the angiotensin-converting enzyme 2 (ACE2), which is found in pancreatic islets, and infection with SARS-CoV-1 has been linked to hyperglycemia in individuals who do not have DM. And hence diabetic patients need to take more precautions and maintain their blood glucose levels. Many pieces of research say that COVID-19 and DM, especially its secondary complications are interlinked. But it also needs more elaborative evidence on whether the anti-diabetic drugs can manage only blood glucose or SARS-CoV-2.
新型冠状病毒肺炎（COVID-19）由严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）引起，截至今日，全球已有超过 2.4537 亿人感染该病毒，超过 490 万人死亡，死亡率为 2.1%。糖尿病（DM）及其继发并发症是当前全球主要的严重健康问题，因为其增长率高，是增长最快的非传染性疾病。根据国际糖尿病联合会（IDF）的数据，每 11 个成年人中就有 1 个患有糖尿病，预计到 2040 年，这一数字将在全球达到 6.42 亿。DM 及其继发并发症的发生也与 COVID-19 的严重程度和高死亡率有关。由于先天免疫缺陷影响吞噬作用、中性粒细胞趋化性和细胞介导的免疫，DM 患者的免疫系统较弱；然而，COVID-19 重症患者中糖尿病的高发可能反映了 2 型糖尿病（T2DM）在老年人中的高发。此外，DM 与老年人的心血管疾病有关，这可能是 COVID-19 与致命结局之间的关联的基础。SARS-CoV-2 通过血管紧张素转换酶 2（ACE2）感染，ACE2 存在于胰岛中，SARS-CoV-1 感染与无 DM 的个体的高血糖有关。因此，糖尿病患者需要采取更多预防措施并保持血糖水平。许多研究表明，COVID-19 和 DM，特别是其继发并发症是相互关联的。但还需要更多关于降糖药物是否仅能控制血糖或 SARS-CoV-2 的详细证据。
