Post-COVID und Diabetes mellitus

In the context of the coronavirus disease 2019 (COVID-19) pandemic, numerous bidirectional influences with noncommunicable diseases such as diabetes mellitus were identified. Current data have been shown to be controversial regarding diverse aspects, most likely due to inconsistent data collection of demographic and regional factors, as well as comorbidities often associated with diabetes. While severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection resulted in increased hyperglycemic derailments with more frequent and pronounced ketoacidosis and steroid-induced diabetes manifestations, poorly controlled glycemic metabolism was associated with increased morbidity and mortality from COVID-19 disease. Severe courses of COVID-19 disease were found to predispose to the occurrence of post-acute COVID syndrome (PACS). Pathophysiologically, chronic subclinical inflammation, insulin resistance, hypoxia, and endothelial dysfunction were identified. In the setting of PACS, prolonged dysglycemia and elevated serum proinflammatory markers have been observed, as well as initial manifestation of type 1 diabetes in childhood. However, to date, an increased prevalence of classic PACS symptoms in diabetic patients has not been detected. Preventive measures include avoidance of infection as well as avoidance of severe courses through vaccination, optimization of blood glucose control, and lifestyle factors.