Insights into the relationship between COVID-19 and diabetes mellitus: Public health perspective

Saurabh RamBihariLal Shrivastava; Prateek Saurabh Shrivastava

doi:10.4103/jms.jms_2_21

REVIEW ARTICLE

Year : 2021 | Volume : 35 | Issue : 2 | Page : 48-50

Insights into the relationship between COVID-19 and diabetes mellitus: Public health perspective

Saurabh RamBihariLal Shrivastava¹, Prateek Saurabh Shrivastava²
¹ Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
² Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission	02-Jan-2021
Date of Decision	02-Aug-2021
Date of Acceptance	16-Aug-2021
Date of Web Publication	27-Nov-2021

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/jms.jms_2_21

Abstract

The coronavirus disease-2019 (COVID-19) pandemic continues to impact the lives of almost everyone across the globe. The present review has been carried out to explore and understand the relationship between COVID-19 infection and diabetes mellitus from the public health perspective. An extensive search of all materials related to the topic was carried out in the PubMed search engine, and a total of 25 research articles were selected based on the suitability with the current review objectives. Keywords used in the search include COVID-19 and Diabetes mellitus in the title alone only. Considering the risk of poor prognosis of infection among diabetics, it has been envisaged that such people should strictly adhere to the preventive measures. Self-care plays a crucial role in the management of diabetes, and the significance of the same has immensely increased during the ongoing COVID-19 pandemic. As the people with diabetes constitute a high-risk group, it is the need of the hour to increase awareness among these people about COVID-19 infection. To conclude, the COVID-19 pandemic is far from over and the people living with diabetes are at significant risk to land up into complications, if they acquire the infection.This call for the need to intensify the preventive strategies and strengthen the health care delivery system for ensuring better management of diabetes among COVID-19 cases.

Keywords: COVID-19 pandemic, diabetes mellitus, self-care, World Health Organization

How to cite this article:
Shrivastava SR, Shrivastava PS. Insights into the relationship between COVID-19 and diabetes mellitus: Public health perspective. J Med Soc 2021;35:48-50

How to cite this URL:
Shrivastava SR, Shrivastava PS. Insights into the relationship between COVID-19 and diabetes mellitus: Public health perspective. J Med Soc [serial online] 2021 [cited 2023 Jun 5];35:48-50. Available from: https://www.jmedsoc.org/text.asp?2021/35/2/48/331339

Introduction

The coronavirus disease-2019 (COVID-19) pandemic continues to impact the lives of almost everyone across the globe. As a matter of fact, as on August 10, 2021, a cumulative total of more than 200 million cases and 4.28 million deaths have been attributed to the novel viral infection.^[1] The global case fatality rate of infection has been estimated as 2.2%, and the infection continues to emerge in different settings.^[1] At the same time, diabetes mellitus has also been acknowledged as a global pandemic with more than 420 million people being diagnosed with the condition and the prevalence of the disease has increased to 8.5% in the year 2014.^[2] Both COVID-19 and diabetes mellitus tend to impair the quality of life and pose a major burden on the health care delivery system.^[3],[4] The present review has been carried out to explore and understand the relationship between COVID-19 infection and diabetes mellitus from the public health perspective.

Methods

An extensive search of all materials related to the topic was carried out in the PubMed search engine. Relevant research articles focusing on patient involvement in medical education published in 2013–2021 were included in the review. A total of 28 studies similar to current study objectives was identified initially, of which, 3 were excluded due to the unavailability of the complete version of the articles. Overall, 25 articles were selected based upon the suitability with the current review objectives and analyzed. Keywords used in the search include COVID-19 and Diabetes mellitus in the title alone only (viz., coronavirus disease 2019 [ti]; COVID-19 [ti]; AND diabetes [ti]). All the articles published in the English language were only selected for the review [Figure 1]. The collected information is presented under the following sub-headings, namely COVID-19 prevalence among diabetics, Diabetics: A vulnerable group for COVID-19, Strengthening prevention component, self-care in diabetes, Implications for practice and implications for research.

Figure 1: Framework for the selection of research articles

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Coronavirus Disease-2019 Prevalence Among Diabetics

Considering the fact that the distribution of diabetes has been global and millions of people are suffering from the condition, there is a significant possibility of acquisition of COVID-19 infection among diabetics.^[5],[6] In fact, the findings of different epidemiological and clinical studies have reported variable prevalence of diabetes among the people detected with COVID-19 infection.^{[5],[6],[7],[8],[9]} The prevalence of diabetes has varied from <10% (in a study conducted among 1099 subjects) to 10%–20% (in a study reporting findings from 339 infected persons) to even more than 20% in a case series reporting findings from seriously ill patients.^[7],[8],[9]

Diabetics: A Vulnerable Group for Coronavirus Disease-2019

People who are living with diabetes have been identified as one of the high-risk groups, which has a poor prognosis of the COVID-19 infection.^{[10],[11],[12],[13]} The people with uncontrolled diabetes are extremely vulnerable as they tend to have uncontrolled blood sugar levels and compromised humoral and innate immunity.^{[11],[12],[13],[14],[15]} These factors, in turn, account for an ineffective defense system and enhances the probability of an exaggerated cytokine storm.^[7] In fact, the currently available evidence suggests that COVID-19 infected diabetics tend to have higher rates of hospital admission, progression to severe forms of pneumonia, more incidence of complications, including deaths, in comparison with those who have no other coexisting illnesses.^{[16],[17],[18]} These diabetics often require hospitalization for the optimal control of blood glucose levels through the administration of insulin and often require close monitoring, which in turn enhances the risk to health care professionals as well.^{[6],[18],[19]}

Strengthening Prevention Component

Considering the risk of poor prognosis of infection among diabetics, it has been envisaged that such people should strictly adhere to the preventive measures (viz., practicing social distancing, staying indoors preferably, regular hand washing with soap and water, avoiding unnecessary travel, following cough etiquettes, etc.).^{[14],[15],[16],[20]} It has been recommended to consume vitamin D supplements, which plays an important role in the glycemic control. The teleconsultation component has been advocated and it has been encouraged to avoid visits to health care facilities unless extremely necessary, as hospitals can act as a source of infection among these vulnerable population groups.^{[15],[16],[20]} Furthermore, considering the availability of effective vaccines, it is of paramount importance to vaccinate the diabetics to ensure that they have some form of immunity against the novel viral infection.^[21]

Self-Care in Diabetes

Self-care plays a crucial role in the management of diabetes, and the significance of the same has immensely increased during the ongoing COVID-19 pandemic.^[22],[23] In an attempt to interrupt the chain of transmission, lockdown has been imposed in multiple nations of varied duration and thus the practice of periodic follow-up has been disrupted for most of the known diabetics.^[24],[25] Thus, it is a must that people with diabetes should strictly take care of their diet, indulge in regular physical activity based on the ability and fitness level, adhere to the drugs, practice self-monitoring of blood glucose, and be aware about symptoms of hypoglycemia or other complications.^{[22],[23],[24],[25]} Wherever possible, the people with diabetes should use the facilities of telemedicine for their well-being, including the management of the psychosocial concerns.^{[23],[24],[25]}

Implications for Practice

As the people with diabetes constitute a high-risk group, it is the need of the hour to increase awareness among these people about COVID-19 infection. There is a need to strengthen the risk communication and community engagement network and ensure that they are informed about the preventive strategies. Further, all the hospitals should look to start teleconsultation, so that a diabetic can avoid their visit to the hospitals for common ailments or for the sake of their regular follow-up.^{[19],[26],[27]} Moreover, there is an indispensable need to encourage people with diabetes to strictly adhere to the prevention of the infection.

Implications for Research

The available studies have not yet conclusively explained the prevalence of COVID-19 among diabetics, and thus, there is a need to conduct large-scale multi-centric research. There has been a lack of clarity about the pathophysiology and the exact mechanism for the increased risk of complications of COVID-19 among diabetics. In general, there is a need to invest in research work and improve our understanding about the COVID-19 infection in people with diabetes.^{[10],[20],[27]}

Conclusion

The COVID19 pandemic is far from over, and the people living with diabetes are at significant risk to land up into complications, if they acquire the infection. This call for the need to intensify the preventive strategies and strengthen the health care delivery system for ensuring better management of diabetes among COVID-19 cases.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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