Considerations for management of patients with diabetes mellitus and acute COVID-19

Diabetes mellitus(DM)is an independent risk factor for admission to intensive care unit and death in patients with coronavirus disease 2019(COVID-19).On the other hand,medications used in the management of COVID-19 are potentially associated with increases in blood glucose levels and a higher incidence of infections.Accordingly,care of patients with DM and acute COVID-19 requires careful consideration of both diseases.Hyperglycemia and hypoglycemia are associated with adverse outcomes and therefore frequent measurement of blood glucose levels and a basal-bolus insulin regimen are required in most patients.Regarding the management of COVID-19,dexamethasone increases blood glucose levels and might also increase the risk for infections.On the other hand,limited data suggest that antiviral and immunomodulatory agents used in COVID-19 are not strongly associated with higher incidence of infections in this population.As knowledge evolves in this field,optimization of the management of both DM and COVID-19 will hopefully improve the outcome of these patients。