Highlights

• Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2; recent modeling of the structure of SARS-CoV-2 spike glycoprotein, which mediates viral-host-cell entry, predicts interactions with dipeptidyl peptidase 4 (DPP4) in addition to angiotensin-converting enzyme 2.
• Increased DPP4 expression and activity are associated with diabetes, obesity, and metabolic syndrome, all of which have been reported to influence COVID-19 severity.
• DPP4 inhibitors (gliptins), which vary in their interactions with the active site of the enzyme, may have immunomodulatory and cardioprotective effects that could be beneficial in COVID-19 cases.

Highlights

• Type 2 diabetes mellitus (T2DM) is associated with chronic inflammation due to underlying insulin resistance and other comorbidities including obesity, older age, hypertension, cardiovascular disease, and dyslipidemia.
• Insulin resistance, hyperglycemia, and elevated angiotensin-converting enzyme 2 (which acts as cellular “receptor” for the virus) leads to heightened inflammation in T2DM.
• We hypothesize that exacerbation of preexisting chronic inflammation and the intense hyperimmune response (“cytokine storm”) play a critical role in increased morbidity and mortality of coronavirus disease 2019 (COVID-19).
• Safe and rigorous blood glucose, blood pressure, and lipid control is recommended in patients with T2DM and COVID-19.

Highlights

• Six microRNAs (miR-148b, miR-223, miR-130a, miR-19a, miR-26b and miR-27b) were selected as potential circulating biomarkers of type 2 diabetes mellitus (T2DM).
• MiR-146a and miR-21 were identified as potential tissue biomarkers of T2DM.

Highlights

• There are ~ 2-fold increased odds of severe coronavirus disease 2019 (COVID-19) and a ~ 2-fold increased risk of odds of mortality in patients with history of diabetes mellitus compared to those without diabetes mellitus.
• Patients with a history of diabetes mellitus should be closely monitored if they get infected with COVID-19.

Results of meta-analysis showing association of diabetes mellitus with severity (Panel A) of disease and mortality (Panel B) in coronavirus disease 2019 (COVID-19) patients

Highlights

• Type 2 diabetes mellitus (T2DM) patients with severe acute respiratory syndrome coronavirus 2 infection had more severe inflammation, coagulation activation, myocardia injury, hepatic injury, and kidney injury. T2DM aggravated the clinical status of coronavirus disease 2019 (COVID-19) patients and increased their critical illness rate and mortality.
• Glucocorticoid treatment and poor fasting blood glucose (≥11.1 mmol/L) control were found to be risk factors of fatality in T2DM patients with severe COVID-19.

Highlights

• Hydroxychloroquine (HCQ) has been shown to exert antihyperglycemic properties by virtue of potential multifaceted effects on glucose homeostasis, including improvement of insulin sensitivity, increase of insulin secretion, and reduction of systemic inflammation.
• Preliminary studies have shown the safety and efficacy of HCQ as an antihyperglycemic agent in type 2 diabetes over a short-term period.
• A careful risk-benefit assessment of HCQ is critical for a cautious use of this drug in diabetic patients, particularly in light of the current COVID-19 pandemic.

Highlights

• Our multicenter study reports a higher proportion of diabetic ketoacidosis presentation of over 60% in newly diagnosed patients with type 1 diabetes with or without confirmed coronavirus disease 2019 (COVID-19) at diagnosis.
• This finding is suggestive of delays in seeking care during the COVID-19 pandemic.