Diabetes and obesity (diabesity) and COVID-19

Czech version

Authors: Ubomíra Fábryová ^1,2,3
Authors‘ workplace: MetabolKLINIK s. r. o., Ambulancia pre diabetológiu, poruchy látkovej premeny a výživy, MED PED centrum, Bratislava ¹; Biomedicínske centrum Slovenskej Akadémie Vied, Bratislava ²; Vysoká škola zdravotníctva a sociálnej práce sv. Alžbety, Inštitút prevencie a intervencie, Bratislava ³
Published in: Forum Diab 2022; 11(1): 15-23
Category:

Overview

The prevalence of diabetes mellitus is increasing worldwide, we are also seeing an increase in the number of individuals with obesity. The relationship between obesity and the development of type 2 diabetes mellitus has long been known. 90 % of type 2 diabetics suffer from overweight or obesity and obesity (visceral obesity) is directly proportional to the risk of developing type 2 diabetes mellitus. We know from recent detailed analyzes from world-renowned institutions that overweight, obesity and diabetes are important predictors of the development of COVID-19-related complications, including the need for hospitalization, intensive care, controlled pulmonary ventilation, but also mortality. Clinical practice shows that the COVID-19 pandemic worsened metabolic compensation in patients with known diabetes mellitus, progression of pre-diabetic stages to type 2 diabetes mellitus, an increase in the number of new diabetics as well as an increase treatment induced diabetes mellitus (antivirals, corticoids). The wide heterogeneity and complexity of this dysmetabolic state (etiology, degree of glycemic disorder, presence of comorbidities, sexual dimorphism in the immune response) leads us to a highly personalized medicine. There are differences between the currently used antidiabetics in both the effectiveness and safety of glycemic control and associated cardiometabolic parameters. We constantly emphasize the importance of euglycemic compensation in diabetics outside and especially during the COVID-19 pandemic. Therefore, it is now important to raise and answer the question of whether the antidiabetics used can minimize the risk of developing and severity of COVID-19 and how to choose antidiabetic treatment in diabetics infected with SARS-CoV-2 at different stages of COVID-19.

Keywords:

DPP-4 inhibitors – type 2 diabetes mellitus – heart failure – COVID-19 – GLP-1 receptor agonists – mortality from COVID-19 – pathophysiological mechanisms – SGLT-2 inhibitors

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