Global experts publish diabetes management and COVID-19 recommendations
An international panel of experts in the field of diabetes and endocrinology have come together to provide practical recommendations for the management of diabetes during the COVID-19 pandemic.
The guidance has been drafted to give healthcare professionals an insight into “potential mechanistic links” between coronavirus and diabetes, while also providing practical management recommendations, and “elaborate on the differential needs of several patient groups”.
The practical recommendations, authored by the research group virtually, are based on queries that have been emphasised to be important by clinicians, questions that have been raised by colleagues and social media and recommendations guided by using focused-literature review.
The researchers said: “Clinical decision making in the management of diabetes is already complex and in normal circumstances we recommend clinicians follow guidelines for management of people with diabetes.
“However, the recommendations authored by our group add to the existing guidelines by considering specific points for the management of patients with diabetes and COVID-19 disease or at risk for metabolic disease.”
In the document they discuss the two specific mechanisms that might play a role in the COVID-19 infection. The first one involves the SARS-CoV-2 virus hijacking an endocrine pathway that plays a crucial role in blood pressure regulation, metabolism, and inflammation.
The second potential mechanism that might explain the link between COVID-19 and diabetes involves the dipeptidyl peptidase-4 (DPP-4) enzyme, which is commonly targeted pharmacologically in people with type 2 diabetes. In cell studies, DPP-4 was identified as a functional receptor for human coronavirus-Erasmus Medical Center (hCoV-EMC), the virus responsible for MERS.