Faruqi Jordana, Balasubramanyam Ashok
Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine, Houston, TX, USA.
Expert Rev Endocrinol Metab. 2023 Mar;18(2):167-179. doi: 10.1080/17446651.2023.2176300. Epub 2023 Feb 16.
The COVID-19 pandemic has changed the landscape of modern medicine on a global scale. An emerging concern is the recognition of a bidirectional relationship between COVID-19 and diabetes. Diabetes is a risk factor for severe COVID-19 illness. Intriguingly, recent epidemiological and studies suggest that infection with SARS-CoV-2, the causative viral agent of COVID-19, is associated with new-onset diabetes and worsening diabetes control. These factors have affected the management of diabetes.
This review provides an overview of our current understanding of the incidence and prevalence of diabetes in relation to the COVID-19 pandemic, highlights studies evaluating SARS-CoV-2's beta cell tropism and its effects on insulin secretion and sensitivity and evaluates the impact of the pandemic on diabetes management and metabolic control.
Epidemiological studies have noted an increase in the incidence of new-onset diabetes associated with COVID-19 in patients with phenotypes of type 1 diabetes, type 2 diabetes and Ketosis-Prone Diabetes. Prospective studies are needed to fully elucidate the association between COVID-19 and diabetes and to characterize persons at risk of developing diabetes after SARS-CoV-2 infection, identify those who should be screened for diabetes, and determine the natural histories of different forms of diabetes associated with COVID-19.
新冠疫情在全球范围内改变了现代医学的格局。一个新出现的问题是认识到新冠病毒与糖尿病之间的双向关系。糖尿病是重症新冠疾病的一个风险因素。有趣的是，最近的流行病学及研究表明，新冠病毒（SARS-CoV-2，新冠疫情的致病病毒）感染与新发糖尿病以及糖尿病控制恶化有关。这些因素影响了糖尿病的管理。
本综述概述了我们目前对与新冠疫情相关的糖尿病发病率和患病率的理解，重点介绍了评估SARS-CoV-2对β细胞的嗜性及其对胰岛素分泌和敏感性影响的研究，并评估了疫情对糖尿病管理和代谢控制的影响。
流行病学研究指出，在1型糖尿病、2型糖尿病和酮症倾向糖尿病表型的患者中，与新冠病毒相关的新发糖尿病发病率有所增加。需要进行前瞻性研究，以充分阐明新冠病毒与糖尿病之间的关联，并确定感染SARS-CoV-2后有患糖尿病风险的人群，确定哪些人应该接受糖尿病筛查，并确定与新冠病毒相关的不同形式糖尿病的自然病程。
