Diabetes and COVID-19: A review / Journal of the ASEAN Federation of Endocrine Societies

@#Coronavirus Disease 2019 (COVID-19) is an emerging disease and since its first identification in Wuhan, China, in December 2019, there has been a rapid increase in cases and deaths across the world. COVID-19 has been shown to have an immense impact in infected persons with diabetes, worsening their outcome, especially in elderly, smokers, obese, those having CVD, CKD, poor glycemic control and long duration of diabetes. In this review we summarize the current understanding of `the impact of COVID-19 on diabetes and discusses the pathophysiological mechanisms and management of diabetes and its complication in this scenario.

Tight glycemic control and cardiovascular effects in type 2 diabetic patients

Diabetes Mellitus [DM] with poor glycemic control is one of the leading causes for cardiovascular mortality in diabetic patients. Tight glycemic control with glycosylated haemoglobin of <7 gms% is recommended as a routine and < 6.5 gms% is recommended for young and newly diagnosed diabetics. Treatment goal aims at achieving near normal blood glucose level, and directed at management of other co morbid conditions such as obesity, hypertension and dyslipidemia. Oral hypoglycemic agents are the preferred drugs, alone or in combination. Preference for glitazones is declining due to the increasing evidences of associated adverse events. Gliptins appear as promising agents with lesser tendency to cause hypoglycemia, but their long term safety and efficacy is yet to be established. We emphasize the role of preventive measures in prediabetics and in established DM, treatment should be individualized and customized to minimize hypoglycemic effects and to retain quality of life

Profile of neurological problems in diabetes mellitus: retrospective analysis of data from 1294 patients

Data from 1294 patients with diabetes mellitus admitted to the Endocrinology Department of the Institute of Medical Sciences, Stringer, Kashmir, from 1986 to 1994, were analyzed for frequency of various neurological problems. Of 1294 patients, 46.29% had clinical evidence of one or more neurological problems. The frequency of neurological problems was significantly more in patients with type II diabetes mellitus [P< 0.001]. Predominant neurological problems included peripheral neuropathy [96.66%], stroke [5.51%], Parkinsonism [1.50%], seizure disorder [1.17%] and dementia [1%]. Mean [ +/- SD] age of patients with neurological problems was significantly more [P< 0.0001] than those without neurological problems [52.07 +/- 9.52] versus 47.45 +/- 12.87 years for type II diabetes mellituts; 26.73 +/- 8.40 versus 18.0 +/- 3.62 for type I diabetes mellitus]. Mean duration of diabetes in patients with neurological problems was significantly more than those without neurological problems [6.70 +/- 6.04 versus 3.95 +/- 4.22 years for type II diabetes mellitus; 5.63 +/- 3.67 versus 1.89 +/- 2.57 for type I diabetes mellitus]. At the time of admission, fasting blood glucose was lower in patients without neurological problems as compared to patients with problems [9.08 +/- 2.22 versus 11.05 +/- 4.91 mmol/L for type II diabetes mellitus; 9, 44 +/- 2.80 versus 13.01 +/- 5.01 mmol/L for type I diabetes mellitus; P< 0.001]