COVID-19 and Diabetes: Risks, outcomes, and management strategies for vulnerable populations

Individuals with diabetes have been greatly affected by the COVID-19 epidemic, highlighting the importance of managing this chronic condition. Diabetes, especially when uncontrolled, can increase the potential for serious sickness and consequences arising from COVID-19. The epidemic has caused significant disruptions in routine diabetes care and access to essential medications and supplies. However, it has also spurred telemedicine and remote monitoring innovations, improving diabetes management. Public health risk efforts have emphasized the importance of vaccination, mask-wearing, and other preventive measures to protect individuals with diabetes and reduce the spread of COVID-19 during the pandemic. Early published reviews on people with diabetes during the COVID-19 pandemic may lack comprehensive data and overlook nuances in diabetes types and social determinants of health risk. A review is needed to synthesize the latest evidence on COVID-19's impact on people with diabetes, addressing risks, outcomes, and management strategies to inform healthcare and policy decisions. This review comprehensively covers the intersection of COVID-19 and diabetes, addressing key areas such as the impact of COVID-19 on diabetes patients, tocilizumab therapy, international guidelines for managing diabetes during the pandemic, the role of diabetes medications, and vulnerable populations. It also explores recovery from the pandemic, the correlation between COVID-19 and diabetes mellitus, as well as the impact of Angiotensin-Converting Enzyme 2 on the infectivity of COVID-19, the occurrence of cytokine storm, and the involvement of the AMPK/mTOR signaling pathway. Moreover, it analyzes the risk factors linked to COVID-19 in persons diagnosed with diabetes and establishes comparisons between those with type 1 and 2 diabetes. Additionally, it reviews the use of telemedicine for managing diabetes, patients undergoing medical treatment for COVID-19, and their glucose-lowering therapies. This review will rectify published reviews' early lacunas and drawbacks by providing a comprehensive and up-to-date analysis of the interaction between COVID-19 and diabetes and address the gaps by synthesizing the latest data on COVID-19's impact on individuals with diabetes, including risks, outcomes, and management strategies.