Patients with diabetes are particularly at risk in the case of infection with Covid-19, especially as this syndrome is often accompanied by other pathologies such as hypertension, cardiovascular disease and obesity. This is what emerges from a study carried out by 4th year residents from the Scuola di specializzazione in Endocrinologia e Malattie del metabolismo at the University of Pisa and published in Lancet Diabetes & Endocrinology. The article contains a systematic assessment of the reasons why Covid-19 implicates a worse prognosis and higher death rate, often 2 or 3 times higher, in patients with diabetes mellitus than in non-diabetic patients.
The study was carried out by Dr. Matteo Apicella, Dr. Maria Cristina Campopiano, Dr. Michele Mantuano and Dr. Laura Mazoni, coordinated by Dr. Alberto Coppelli (Section of Diabetes and Metabolic Diseases of the AOUP) and by Professor Stefano Del Prato (photo on the right), professor of Endocrinology and Chief of the Section.
From the outset of the pandemic, scientific studies on the risks from Covid-19 have focused on patients with diabetes precisely because of their intrinsic ‘vulnerability’, whether it be diabetes mellitus type 2 or type 1. Age, sex and ethnicity were also noted to be amongst the many concomitant risk factors. Anti-cholesterol drugs and antiviral treatment may modulate the risks but the limitations to their use and the potential interaction with anti-Covid-19 treatment must be carefully managed. Finally, the acute respiratory syndrome caused by Covid-19 can lead to metabolic complications in patients with diabetes such as diabetic ketoacidosis or the onset of hyperglycaemia in those patients with undiagnosed or recently discovered diabetes, once they are admitted to hospital.