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Article ; Online: Diabetes and COVID19: a bidirectional relationship.

Unnikrishnan, Ranjit / Misra, Anoop

2021 Volume 75, Issue 9, Page(s) 1332–1336

Abstract: ... focused attention on the relationship of commonly occurring comorbidities such as diabetes on the course ... and outcomes of this infection. While diabetes does not seem to be associated with an increased risk ... hyperglycemia and diabetes, and worsening of glycemic control in pre-existing diabetes, due to direct pancreatic ...

Abstract	The advent and rapid spread of the coronavirus disease-2019 (COVID19) pandemic across the world has focused attention on the relationship of commonly occurring comorbidities such as diabetes on the course and outcomes of this infection. While diabetes does not seem to be associated with an increased risk of COVID19 infection per se, it has been clearly demonstrated that the presence of hyperglycemia of any degree predisposes to worse outcomes, such as more severe respiratory involvement, ICU admissions, need for mechanical ventilation and mortality. Further, COVID19 infection has been associated with the development of new-onset hyperglycemia and diabetes, and worsening of glycemic control in pre-existing diabetes, due to direct pancreatic damage by the virus, body's stress response to infection (including cytokine storm) and use of diabetogenic drugs such as corticosteroids in the treatment of severe COVID19. In addition, public health measures taken to flatten the pandemic curve (such as lockdowns) can also adversely impact persons with diabetes by limiting their access to clinical care, healthy diet, and opportunities to exercise. Most antidiabetic medications can continue to be used in patients with mild COVID19 but switching over to insulin is preferred in severe disease.
MeSH term(s)	COVID-19 ; Communicable Disease Control ; Diabetes Mellitus/epidemiology ; Humans ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2021-06-23
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	639358-5
ISSN	1476-5640 ; 0954-3007
ISSN (online)	1476-5640
ISSN	0954-3007
DOI	10.1038/s41430-021-00961-y
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Article ; Online: Diabetes and COVID19: a bidirectional relationship.

Unnikrishnan, Ranjit / Misra, Anoop

Nutrition & diabetes

2021 Volume 11, Issue 1, Page(s) 21

Abstract	The advent and rapid spread of the coronavirus disease-2019 (COVID19) pandemic across the world has focused attention on the relationship of commonly occurring comorbidities such as diabetes on the course and outcomes of this infection. While diabetes does not seem to be associated with an increased risk of COVID19 infection per se, it has been clearly demonstrated that the presence of hyperglycemia of any degree predisposes to worse outcomes, such as more severe respiratory involvement, ICU admissions, need for mechanical ventilation and mortality. Further, COVID19 infection has been associated with the development of new-onset hyperglycemia and diabetes, and worsening of glycemic control in pre-existing diabetes, due to direct pancreatic damage by the virus, body's stress response to infection (including cytokine storm) and use of diabetogenic drugs such as corticosteroids in the treatment of severe COVID19. In addition, public health measures taken to flatten the pandemic curve (such as lockdowns) can also adversely impact persons with diabetes by limiting their access to clinical care, healthy diet, and opportunities to exercise. Most antidiabetic medications can continue to be used in patients with mild COVID19 but switching over to insulin is preferred in severe disease.
MeSH term(s)	Blood Glucose ; COVID-19/blood ; COVID-19/complications ; Communicable Disease Control ; Diabetes Mellitus, Type 1/blood ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/complications ; Humans ; Pandemics
Chemical Substances	Blood Glucose
Language	English
Publishing date	2021-06-23
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2609314-5
ISSN	2044-4052 ; 2044-4052
ISSN (online)	2044-4052
ISSN	2044-4052
DOI	10.1038/s41387-021-00163-2
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Article ; Online: Covid-19 and Diabetes

Muniangi-Muhitu, Hermine / Akalestou, Elina / Salem, Victoria / Misra, Shivani / Oliver, Nicholas S. / Rutter, Guy A.

Frontiers in Endocrinology

A Complex Bidirectional Relationship

2020 Volume 11

Keywords	covid19
Publisher	Frontiers Media SA
Publishing country	ch
Document type	Article ; Online
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2020.582936
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Covid-19 and diabetes

Muniangi-Muhitu, H / Akalestou, E / Salem, V / Misra, S / Oliver, NS / Rutter, GA

a complex bidirectional relationship

2020

Abstract: ... severity and death from SARS-Cov2 infection include older age, male sex, diabetes, obesity and hypertension ... 19 and, additionally, how diabetic emergencies and longer term pathology may be aggravated ... of microangiopathy in severe Covid-19 infection and the potential for direct viral toxicity on metabolically-relevant ...

Abstract	Covid-19 is a recently-emerged infectious disease caused by the novel severe acute respiratory syndrome coronavirus SARS-CoV2. SARS-CoV2 differs from previous coronavirus infections (SARS and MERS) due to its high infectivity (reproduction value, R0, typically 2-4) and pre- or asymptomatic transmission, properties that have contributed to the current global Covid-19 pandemic. Identified risk factors for disease severity and death from SARS-Cov2 infection include older age, male sex, diabetes, obesity and hypertension. The reasons for these associations are still largely obscure. Evidence is also emerging that SARS-CoV2 infection exacerbates the underlying pathophysiology of hyperglycemia in people with diabetes. Here, we discuss potential mechanisms through which diabetes may affect the risk of more severe outcomes in Covid-19 and, additionally, how diabetic emergencies and longer term pathology may be aggravated by infection with the virus. We consider roles for the immune system, the observed phenomenon of microangiopathy in severe Covid-19 infection and the potential for direct viral toxicity on metabolically-relevant tissues including pancreatic beta cells and targets of insulin action.
Keywords	Covid-19 ; diabetes ; ketoacidosis ; management ; microangiopathy ; 1103 Clinical Sciences ; 1111 Nutrition and Dietetics ; covid19
Language	English
Publishing date	2020-09-08
Publisher	Frontiers Media
Publishing country	uk
Document type	Article ; Online
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Article ; Online: Covid-19 and Diabetes

Hermine Muniangi-Muhitu / Elina Akalestou / Victoria Salem / Shivani Misra / Nicholas S. Oliver / Guy A. Rutter

Frontiers in Endocrinology, Vol

A Complex Bidirectional Relationship

2020 Volume 11

Abstract	Covid-19 is a recently-emerged infectious disease caused by the novel severe acute respiratory syndrome coronavirus SARS-CoV2. SARS-CoV2 differs from previous coronavirus infections (SARS and MERS) due to its high infectivity (reproduction value, R0, typically 2–4) and pre- or asymptomatic transmission, properties that have contributed to the current global Covid-19 pandemic. Identified risk factors for disease severity and death from SARS-Cov2 infection include older age, male sex, diabetes, obesity and hypertension. The reasons for these associations are still largely obscure. Evidence is also emerging that SARS-CoV2 infection exacerbates the underlying pathophysiology of hyperglycemia in people with diabetes. Here, we discuss potential mechanisms through which diabetes may affect the risk of more severe outcomes in Covid-19 and, additionally, how diabetic emergencies and longer term pathology may be aggravated by infection with the virus. We consider roles for the immune system, the observed phenomenon of microangiopathy in severe Covid-19 infection and the potential for direct viral toxicity on metabolically-relevant tissues including pancreatic beta cells and targets of insulin action.
Keywords	diabetes ; Covid-19 ; ketoacidosis ; management ; microangiopathy ; Diseases of the endocrine glands. Clinical endocrinology ; RC648-665 ; covid19
Subject code	610
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Covid-19 and Diabetes: A Complex Bidirectional Relationship.

Muniangi-Muhitu, Hermine / Akalestou, Elina / Salem, Victoria / Misra, Shivani / Oliver, Nicholas S / Rutter, Guy A

Frontiers in endocrinology

2020 Volume 11, Page(s) 582936

Abstract: ... severe acute respiratory syndrome coronavirus SARS-CoV2. SARS-CoV2 differs from previous coronavirus infections (SARS and MERS) due ... Covid-19 is a recently-emerged infectious disease caused by the novel ...

Abstract	Covid-19 is a recently-emerged infectious disease caused by the novel severe acute respiratory syndrome coronavirus SARS-CoV2. SARS-CoV2 differs from previous coronavirus infections (SARS and MERS) due to its high infectivity (reproduction value, R
MeSH term(s)	Betacoronavirus/isolation & purification ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/transmission ; Coronavirus Infections/virology ; Diabetes Complications ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/virology ; Humans ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/transmission ; Pneumonia, Viral/virology ; Risk Factors ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-10-08
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2020.582936
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Article ; Online: Metabolic liver disease in diabetes - From mechanisms to clinical trials.

Dewidar, Bedair / Kahl, Sabine / Pafili, Kalliopi / Roden, Michael

Metabolism: clinical and experimental

2020 Volume 111S, Page(s) 154299

Abstract: ... This review addresses the bidirectional relationship between mechanisms underlying T2DM and NAFLD ... of diabetes-related cardiovascular and kidney diseases, underpinning the critical role of insulin resistance ... syndrome, and type 2 diabetes mellitus (T2DM). Both multisystem diseases share several common mechanisms ...

Abstract	Non-alcoholic fatty liver disease (NAFLD) comprises fatty liver (steatosis), non-alcoholic steatohepatitis (NASH) and fibrosis/cirrhosis and may lead to end-stage liver failure or hepatocellular carcinoma. NAFLD is tightly associated with the most frequent metabolic disorders, such as obesity, metabolic syndrome, and type 2 diabetes mellitus (T2DM). Both multisystem diseases share several common mechanisms. Alterations of tissue communications include excessive lipid and later cytokine release by dysfunctional adipose tissue, intestinal dysbiosis and ectopic fat deposition in skeletal muscle. On the hepatocellular level, this leads to insulin resistance due to abnormal lipid handling and mitochondrial function. Over time, cellular oxidative stress and activation of inflammatory pathways, again supported by multiorgan crosstalk, determine NAFLD progression. Recent studies show that particularly the severe insulin resistant diabetes (SIRD) subgroup (cluster) associates with NAFLD and its accelerated progression and increases the risk of diabetes-related cardiovascular and kidney diseases, underpinning the critical role of insulin resistance. Consequently, lifestyle modification and certain drug classes used to treat T2DM have demonstrated effectiveness for treating NAFLD, but also some novel therapeutic concepts may be beneficial for both NAFLD and T2DM. This review addresses the bidirectional relationship between mechanisms underlying T2DM and NAFLD, the relevance of novel biomarkers for improving the diagnostic modalities and the identification of subgroups at specific risk of disease progression. Also, the role of metabolism-related drugs in NAFLD is discussed in light of the recent clinical trials. Finally, this review highlights some challenges to be addressed by future studies on NAFLD in the context of T2DM.
MeSH term(s)	Animals ; Biomarkers/metabolism ; Diabetes Mellitus, Type 2/metabolism ; Diabetes Mellitus, Type 2/pathology ; Disease Progression ; Humans ; Liver Cirrhosis/metabolism ; Liver Cirrhosis/pathology ; Metabolic Syndrome/metabolism ; Metabolic Syndrome/pathology ; Non-alcoholic Fatty Liver Disease/metabolism ; Non-alcoholic Fatty Liver Disease/pathology ; Risk
Chemical Substances	Biomarkers
Keywords	covid19
Language	English
Publishing date	2020-06-20
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	80230-x
ISSN	1532-8600 ; 0026-0495
ISSN (online)	1532-8600
ISSN	0026-0495
DOI	10.1016/j.metabol.2020.154299
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Article ; Online: Arterial Stiffness Preceding Diabetes: A Longitudinal Study.

Zheng, Mengyi / Zhang, Xinyuan / Chen, Shuohua / Song, Yongjian / Zhao, Quanhui / Gao, Xiang / Wu, Shouling

Circulation research

2020 Volume 127, Issue 12, Page(s) 1491–1498

Abstract: Rationale: Previous studies on the relationship between diabetes and arterial stiffness were ... Whether the association between arterial stiffness and diabetes is bidirectional remains unclear to date.: Objective ... ankle pulse wave velocity (baPWV) from 2010 to 2015, and free of diabetes, cardiovascular and ...

Abstract	Rationale: Previous studies on the relationship between diabetes and arterial stiffness were mostly cross-sectional. A few longitudinal studies focused on one single direction. Whether the association between arterial stiffness and diabetes is bidirectional remains unclear to date. Objective: To explore the temporal relationship between arterial stiffness and fasting blood glucose (FBG) status. Methods and results: Included were 14 159 participants of the Kailuan study with assessment of brachial-ankle pulse wave velocity (baPWV) from 2010 to 2015, and free of diabetes, cardiovascular and cerebrovascular diseases, and chronic kidney disease at baseline. FBG and baPWV were repeatedly measured at baseline and follow-ups. Cox proportional hazard regression model was used to estimate hazard ratios and 95% confidence intervals (CIs) of incident diabetes across baseline baPWV groups: <1400 cm/s (ref), 1400≤ baPWV <1800 cm/s, and ≥1800 cm/s. Path analysis was used to analyze the possible temporal causal relationship between baPWV and FBG, among 8956 participants with repeated assessment of baPWV and FBG twice in 2010 to 2017. The mean baseline age of the observed population was 48.3±12.0 years. During mean 3.72 years of follow-up, 979 incident diabetes cases were identified. After adjusting for potential confounders, the hazard ratio (95% CI) for risk of diabetes was 1.59 (1.34-1.88) for the borderline arterial stiffness group and 2.11 (1.71-2.61) for the elevated arterial stiffness group, compared with the normal ideal arterial stiffness group. In the path analysis, baseline baPWV was associated with follow-up FBG (the standard regression coefficient was 0.09 [95% CI, 0.05-0.10]). In contrast, the standard regression coefficient of baseline FBG for follow-up baPWV (β=0.00 [95% CI, -0.02 to 0.02]) was not significant. Conclusions: Arterial stiffness, as measured by baPWV, was associated with risk of developing diabetes. Arterial stiffness appeared to precede the increase in FBG.
MeSH term(s)	Adult ; Aged ; Ankle Brachial Index ; Biomarkers/blood ; Blood Glucose/metabolism ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/physiopathology ; China/epidemiology ; Diabetes Mellitus/diagnosis ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/physiopathology ; Female ; Humans ; Incidence ; Longitudinal Studies ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Pulse Wave Analysis ; Risk Assessment ; Risk Factors ; Time Factors ; Vascular Stiffness
Chemical Substances	Biomarkers ; Blood Glucose
Keywords	covid19
Language	English
Publishing date	2020-09-28
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80100-8
ISSN	1524-4571 ; 0009-7330 ; 0931-6876
ISSN (online)	1524-4571
ISSN	0009-7330 ; 0931-6876
DOI	10.1161/CIRCRESAHA.120.317950
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Article: New onset diabetes, type 1 diabetes and COVID-19

Boddu, Sirisha Kusuma Aurangabadkar Geeta Kuchay Mohammad Shafi

Diabetes & Metabolic Syndrome: Clinical Research & Reviews

Abstract: ... the possibility of COVID 19 induced diabetes and highlights a potential bidirectional link between COVID 19 and ... studies describing relationship between COVID-19 and T1DM Results Past lessons and new data teach ... electronic databases till October 2020, using relevant keywords (COVID-19 induced diabetes;COVID-19 and type ...

Abstract	Background and aims New data has emerged regarding higher risk of coronavirus disease 2019 (COVID-19), and its severity and complications in patients with type 2 diabetes mellitus (T2DM) However, there is a dearth of evidence regarding type 1 diabetes mellitus (T1DM) This article explores the possibility of COVID 19 induced diabetes and highlights a potential bidirectional link between COVID 19 and T1DM Methods A literature search was performed with Medline (PubMed), Scopus, and Google Scholar electronic databases till October 2020, using relevant keywords (COVID-19 induced diabetes;COVID-19 and type 1 diabetes;COVID-19 induced DKA;new-onset diabetes after SARS-CoV-2 infection) to extract relevant studies describing relationship between COVID-19 and T1DM Results Past lessons and new data teach us that severe acute respiratory syndrome coronaviruses (SARS CoV-1, -2) can enter islet cells via angiotensin converting enzyme-2 (ACE-2) receptors and cause reversible β-cell damage and transient hyperglycemia There have been postulations regarding the potential new-onset T1DM triggered by COVID-19 This article reviewed all the available evidence regarding the impact and interlink between COVID-19 and Τ1DM We also intended to explore the mechanisms behind the viral etiology of Τ1DM Conclusions SARS CoV-2 induces new-onset diabetes with diabetic ketoacidosis at presentation in several individuals However, at present, there is no hard evidence that SARS CoV-2 induces T1DM Long term follow-up of children and adults presenting with new-onset diabetes during this pandemic is required to fully understand the type of diabetes induced by COVID-19
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #926259
Database	COVID19

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Article ; Online: Infections and diabetes: Risks and mitigation with reference to India.

Unnikrishnan, Ranjit / Misra, Anoop

Diabetes & metabolic syndrome

2020 Volume 14, Issue 6, Page(s) 1889–1894

Abstract: ... well controlled diabetes (bidirectional relationship). Diabetes does not increase the risk of infection ... Background and aims: The link between diabetes and increased risk of infectious disease has long ... A literature search was conducted in PubMed for articles in English on diabetes and infection.: Results ...

Abstract	Background and aims: The link between diabetes and increased risk of infectious disease has long been recognized, but has re-entered sharp focus following the COVID-19 pandemic. Methods: A literature search was conducted in PubMed for articles in English on diabetes and infection. Results: Diabetes predisposes to infections through alterations in innate and acquired immune defenses. Outcomes of infection are worse in people with uncontrolled diabetes, and infection can worsen hyperglycemia in hitherto well controlled diabetes (bidirectional relationship). Diabetes does not increase the risk of infection with COVID-19 per se, but predisposes to severe disease and poor outcomes. COVID-19 has also been linked to deterioration of glycemic control as well as new-onset diabetes. Conclusions: Clinicians caring for people with diabetes should be aware of the increased risk of infections in this population, as well as the possibility of worsening hyperglycemia. A holistic approach with frequent monitoring of blood glucose levels and appropriate titration of medications, along with close attention to nutritional status, is essential to ensure the best possible outcomes.
MeSH term(s)	Adaptive Immunity/immunology ; Blood Glucose/metabolism ; COVID-19/epidemiology ; COVID-19/immunology ; COVID-19/metabolism ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/immunology ; Diabetes Mellitus/metabolism ; Glycemic Control ; Humans ; Immunity, Innate/immunology ; India/epidemiology ; Infections/epidemiology ; Infections/immunology ; Infections/metabolism ; Reproductive Tract Infections/epidemiology ; Reproductive Tract Infections/immunology ; Reproductive Tract Infections/metabolism ; Respiratory Tract Infections/epidemiology ; Respiratory Tract Infections/immunology ; Respiratory Tract Infections/metabolism ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; Skin Diseases, Bacterial/epidemiology ; Skin Diseases, Bacterial/immunology ; Skin Diseases, Bacterial/metabolism ; Soft Tissue Infections/epidemiology ; Soft Tissue Infections/immunology ; Soft Tissue Infections/metabolism ; Tuberculosis, Pulmonary/epidemiology ; Tuberculosis, Pulmonary/immunology ; Tuberculosis, Pulmonary/metabolism ; Urinary Tract Infections/epidemiology ; Urinary Tract Infections/immunology ; Urinary Tract Infections/metabolism
Chemical Substances	Blood Glucose
Keywords	covid19
Language	English
Publishing date	2020-09-22
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2273766-2
ISSN	1878-0334 ; 1871-4021
ISSN (online)	1878-0334
ISSN	1871-4021
DOI	10.1016/j.dsx.2020.09.022
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