Diabetes (also known as sugar diabetes) is a condition that occurs when the body can’t use glucose normally. As glucose is the main source of energy for the body’s cells. Glucose is made by the pancreas and the levels of glucose in the blood are controlled by a hormone called Insulin. Insulin helps glucose enter the cells. Diabetes is of two types: First, When the pancreas does not make enough insulin so-known as type 1 diabetes, and secondly when the body can’t respond normally to the insulin that is made, so-known as type 2 diabetes. This increases the glucose levels in the blood, leading to symptoms such as increased urination, extreme thirst, and unexplained weight loss.
In patients with diabetes mellitus, uncontrolled hyperglycemia leads to primarily vascular complications that affect small vessels (microvascular) and large vessels (macrovascular), or both.
1) Microvascular disease underlies 3 common manifestations of diabetes mellitus:
a) Retinopathy
b) Nephropathy
c) Neuropathy
2) Macrovascular disease involves atherosclerosis of large vessels, which can lead to:
a) Angina pectoris and myocardial infarction
b) Transient ischemic attacks and strokes
c) Peripheral arterial disease
3) Immune dysfunction is another major complication and develops from the direct effects of hyperglycemia on cellular immunity. Diabetic patients are particularly more susceptible to bacterial and fungal infections.
People with diabetes are prone to Infections of any kind either viral, bacterial, or fungal because their bodies do not process glucose as well during illness, their immune response is weaker, and their circulation is impaired. So Older people and people with pre-existing conditions such as diabetes are more likely to get infected with Covid-19 and also pose a greater risk of mortality in COVID-19 patients. Therefore, it is important to maintain good control of this non-communicable disease, especially in the elderly above 60 years of age. In people with diabetes, as there is a possibility of disruption to the routine lifestyle management measures like physical activity and psychological stress management due to Covid, so they must explore ways to manage their diet, exercise, and stress and consult with the treating physician to prevent worsening of control. Both increased and low levels of blood glucose can compromise immunity, thus making the patient more susceptible to infections.
People with diabetes tend to live in a chronic inflammatory state, increases the risk of the severe inflammatory response to Covid-19 that can lead to a life-threatening cytokine storm. Thus, this immune overreaction is thought to harm some people more through organ damage than via the actual viral infection. But diabetes can also weaken the immune system that fights viruses. People with type 2 diabetes also have more ACE2(Angiotensin-converting enzyme 2) receptors in many tissues, including those lining blood vessels, thus opening many more doors to the Covid-19 invasion. Coronavirus’s spike protein uses ACE2 to gain entry into cells.
For more information, you can visit BioMedCentral.
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