Zhao Xuefei, Jiang Linlin, Sun Wenjie, Tang Shanshan, Kang Xiaomin, Gao Qing, Li Zehua, An Xuedong, Lian Fengmei
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Beijing University of Chinese Medicine, Beijing, China.
Front Endocrinol (Lausanne). 2025 May 21;16:1599969. doi: 10.3389/fendo.2025.1599969. eCollection 2025.
The global pandemic caused by the SARS-CoV-2 virus has had a profound impact on the onset, progression, and management of diabetes, posing significant challenges to healthcare systems worldwide. This review elucidates the multifaceted impact of SARS-CoV-2 on diabetes mellitus, emphasizing the increased complexity of glycemic management in patients with SARS-CoV-2 infection following viral infection in the postpandemic era. In this study, we examined the diverse effects of the SARS-CoV-2 virus on individuals with diabetes. These effects included an elevated risk of morbidity, erratic fluctuations in blood glucose levels, the emergence of complications associated with diabetes, and the emergence of challenges related to self-management of the disease. From a mechanistic perspective, we investigated the following factors: SARS-CoV-2-mediated direct damage to islet beta cells, dysregulation of the RAAS system, impairment of islet function by oxidative stress, and the effects of the integrated stress response, stress response, and reduced adiponectin levels on insulin utilization efficiency and glucose metabolism. Furthermore, viral effects extend to diabetic complications and cardiovascular risk factors, such as coagulation abnormalities, hypertension, and lipid metabolism. This results in an exacerbation of the development of diabetic complications. This review highlights the urgent need for refined management strategies for patients with diabetes during the pandemic and in the later stages of COVID-19. Additionally, there is a need for integrated management strategies to mitigate the impact of COVID-19 on the long-term outcomes of patients with diabetes.
由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒引起的全球大流行对糖尿病的发病、进展和管理产生了深远影响，给全球医疗系统带来了重大挑战。本综述阐明了SARS-CoV-2对糖尿病的多方面影响，强调了在大流行后时代，SARS-CoV-2感染患者血糖管理的复杂性增加。在本研究中，我们研究了SARS-CoV-2病毒对糖尿病患者的多种影响。这些影响包括发病风险升高、血糖水平波动不定、糖尿病相关并发症的出现以及疾病自我管理方面的挑战。从机制角度来看，我们研究了以下因素：SARS-CoV-2介导的胰岛β细胞直接损伤、肾素-血管紧张素-醛固酮系统（RAAS）失调、氧化应激对胰岛功能的损害，以及综合应激反应、应激反应和脂联素水平降低对胰岛素利用效率和葡萄糖代谢的影响。此外，病毒的影响还扩展到糖尿病并发症和心血管危险因素，如凝血异常、高血压和脂质代谢。这导致糖尿病并发症的发展加剧。本综述强调了在大流行期间以及新冠肺炎后期对糖尿病患者采取精细化管理策略的迫切需求。此外，还需要综合管理策略来减轻新冠肺炎对糖尿病患者长期预后的影响。
