Importance of diabetes management during the COVID-19 pandemic

ABSTRACT

Uncontrolled diabetes and/or hyperglycemia is associated with severe COVID-19 disease and increased mortality. It is now known that poor glucose control before hospital admission can be associated with a high risk of in-hospital death. By achieving and maintaining glycemic control, primary care physicians (PCPs) play a critical role in limiting this potentially devastating outcome. Further, despite the hope that mass vaccination will help control the pandemic, genetic variants of the virus are causing surges in some countries. As such, PCPs will treat an increasing number of patients with diabetes who have symptoms of post–COVID-19 infection, or even have new-onset type 2 diabetes as a result of COVID-19 infection. However, much of the literature published focuses on the effects of COVID-19 in hospitalized patients, with few publications providing information and advice to those caring for people with diabetes in the primary care setting. This manuscript reviews the current knowledge of the risk and outcomes of individuals with diabetes who are infected with COVID-19 and provides information for PCPs on the importance of glucose control, appropriate treatment, and use of telemedicine and online prescription delivery systems to limit the potentially devastating effects of COVID-19 in people with hyperglycemia.

KEYWORDS:

• COVID-19
• diabetes
• hyperglycemia
• hemoglobin A1c
• primary care

Acknowledgments

The authors received writing and editorial support in the preparation of this manuscript, provided by Barrie Anthony and Helen Jones of Evidence Scientific Solutions, and funded by Sanofi US.

Disclosure statement

JP reports that he has served as a consultant for Diasome, Lexicon, Mannkind, Novo Nordisk, and Sanofi.

NS reports nonfinancial support from AstraZeneca, Boehringer Ingelheim, Sanofi, Bayer, and GlaxoSmithKline (GSK); personal fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, and GSK; and serving on advisory boards of AstraZeneca, Boehringer Ingelheim, Teva Pharmaceutical, Eli Lilly, Sanofi, Sanofi Pasteur, GSK, and Bayer.

A reviewer on this manuscript has disclosed that in the past (until 2017) they have received honoraria and travel grants and have served on advisory boards for Novo Nordisk, Eli Lilly, Ethicon, Pfizer Inc., Sanofi-Aventis, AstraZeneca, Merck-Serono, Boehringer Ingelheim, Janssen, and Novartis. The other peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Author contributions

Both authors contributed to the manuscript concept, critically reviewed and revised the drafts and reviewed and approved of the final draft. Both authors are accountable for the content of this manuscript.

Additional information

Funding

Writing support for this manuscript was funded by Sanofi US.