Hemat Jouy Shaghayegh, Tonchev Harry, Mostafa Sarah M, Mahmoud Abeer M
Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Central Tehran Branch, Islamic Azad University, Tehran 11369, Iran.
Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.
Biomedicines. 2025 Jun 16;13(6):1482. doi: 10.3390/biomedicines13061482.
Emerging evidence highlights the profound and lasting impact of severe illnesses such as COVID-19, particularly among individuals with underlying comorbidities. Patients with pre-existing conditions like diabetes mellitus (DM) are disproportionately affected, facing heightened risks of both disease exacerbation and the onset of new complications. Notably, the convergence of advanced age and DM has been consistently associated with poor COVID-19 outcomes. However, the long-term metabolic consequences of SARS-CoV-2 infection, especially its role in disrupting glucose homeostasis and potentially triggering or worsening DM, remain incompletely understood. This review synthesizes current clinical and experimental findings to clarify the bidirectional relationship between COVID-19 and diabetes. We critically examine literature reporting deterioration of glycemic control, onset of hyperglycemia in previously non-diabetic individuals, and worsening of metabolic parameters in diabetic patients after infection. Furthermore, we explore proposed mechanistic pathways, including pancreatic β-cell dysfunction, systemic inflammation, and immune-mediated damage, that may underpin the development or progression of DM in the post-COVID setting. Collectively, this work underscores the urgent need for continued research and clinical vigilance in managing metabolic health in COVID-19 survivors.
新出现的证据凸显了诸如COVID-19等严重疾病的深远和持久影响,尤其是在患有基础合并症的个体中。患有糖尿病(DM)等既往疾病的患者受到的影响尤为严重,面临疾病加重和新并发症发作的风险增加。值得注意的是,高龄与DM并存一直与COVID-19的不良预后相关。然而,SARS-CoV-2感染的长期代谢后果,尤其是其在破坏葡萄糖稳态以及潜在引发或加重DM方面的作用,仍未完全了解。本综述综合了当前的临床和实验结果,以阐明COVID-19与糖尿病之间的双向关系。我们批判性地审视了有关血糖控制恶化、既往非糖尿病个体出现高血糖以及感染后糖尿病患者代谢参数恶化的文献报道。此外,我们探讨了可能是COVID-19后DM发生或进展基础的潜在机制途径,包括胰腺β细胞功能障碍、全身炎症和免疫介导的损伤。总体而言,这项工作强调了在管理COVID-19幸存者代谢健康方面持续研究和临床警惕的迫切需求。
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