Management of diabetes patients during the covid-19 epidemic

Abstract

The year 2020 will undoubtedly be marked by the coronavirus disease 2019 (covid-19) pandemic, caused by the novel coronavirus SARS-CoV-2. It has been shown that in diabetes patients, covid-19 occurs in a more severe form, with these patients being more prone to the need for mechanical ventilation and having higher mortality rates than non-diabetic patients. In the present article, we describe possible pathophysiological mechanisms that could explain a more severe course of covid-19 in diabetes patients. We also describe the recommendations for use and discontinuation of anti-diabetic drugs during infection, and continue by explaining how to adjust the management of this chronic disease during an epidemic. In conclusion, our own experience in organizing outpatient diabetes clinic during the covid-19 epidemic at the University Medical Centre Ljubljana is described. Covid-19 still carries many unknowns, so it will not surprise us, if we soon realize that the findings described so far, are outdated. Nonetheless, the present recommendations for the treatment of diabetes patients during the epidemic will remain in force and will hopefully help to improve and optimize the treatment of our patients, even after the pandemic.