Managing COVID-19 alone can be a difficult in many cases, but for persons with pre-existing conditions such as diabetes the challenge can be all the greater, and specific considerations need to be taken when prescribing treatment to manage them. This book is a culmination of scientific work driven by personal conviction to enhance the care provided to the vulnerable populations COVID-19 patients with diabetes. It spans topics from the epidemiology and predictors of complications and increased mortality in COVID-19, to in-depth discussion of the pathophysiology of the disease. Pathophysiology of COVID-19 is addressed comprehensively as common soil pathogenetic pathways, and by organ system such as the lung, the kidney and most pertinently for diabetes, the diabetic foot ulcers and diabetes co-morbidities. A multi-disciplinary approach was needed to manage these complex patients; thus, the authors represent a variety of disciplines including pharmacology, endocrinology, nephrology, infectious diseases, podiatry, vascular surgery, pulmonary/critical care, and general medicine.
Written by experts in the field, Diabetes and COVID-19: Considerations and Clinical Management is a blueprint for treatment of patients with both conditions.
Author(s): Alyson K. Myers
Series: Contemporary Endocrinology
Publisher: Springer
Year: 2023
Language: English
Pages: 224
City: Cham
Foreword
Preface
Acknowledgment
Contents
List of Contributors
Part I: Pathophysiology
Chapter 1: COVID-19: Epidemiology, Etiology, Clinical Manifestations, Diagnosis, Therapeutic Options, and Prevention
Etiology
Clinical Manifestations
Diagnosis
Management
Outpatient Management
Therapeutics
Inpatient Management
Prevention
Conclusions
References
Chapter 2: Pathophysiology: How COVID-19 Impacts the Pancreas and Peripheral Insulin Resistance
Background
COVID-19 Infection and the Pancreas
Autopsy Evidence for Pancreatic Involvement
Angiotensin-Converting Enzyme 2 and Transmembrane Protease Serine 2 Expression in the Pancreas
Neuropilin 1 and Transferrin Receptor
SARS-CoV-2 and β-Cell Transdifferentiation
Pancreatitis
Summary
COVID-19 and Peripheral Insulin Resistance
Adipokines and Insulin Resistance
Prolonged Insulin Resistance
Summary
Conclusion
References
Chapter 3: Risk of COVID-19 in Persons with Diabetes
Introduction
Prevalence and the Risk of Diabetes in Respiratory Viral Infections
Prevalence and Risk of Diabetes and COVID-19
How the Immunity of Persons with Diabetes Is Impacted by Inflammation of COVID-19
Risk of New-Onset Diabetes with COVID-19
Risk of COVID-19 in Patients with Type 1 Diabetes
Risk of COVID-19 in Children with Diabetes
Risk of COVID-19 in Patients with Prediabetes
Risk of COVID-19 in Patients with Gestational Diabetes Mellitus
Risk of COVID-19 in Patients with Type 2 Diabetes
The Risk of Mortality, Severity of Disease, and Glycemic Control and COVID-19
Conclusion
References
Chapter 4: Pathophysiology of Lung Dysfunction in Diabetes
Introduction
The Association Between Diabetes and Lung Disease
Lung Pathophysiology of COVID-19 in Diabetes
COVID-19, Diabetes, and Asthma
COVID-19, Diabetes, and Chronic Obstructive Pulmonary Disease
COVID-19, Diabetes, and Pulmonary Fibrosis
COVID-19, Diabetes, and Acute Respiratory Distress Syndrome
COVID-19, Diabetes, and Thromboembolic Disorder
COVID-19’s Impact on those with Cystic Fibrosis Bronchiectasis and Diabetes
Conclusion
References
Part II: COVID and Diabetes Complications
Chapter 5: Diabetic Kidney Disease and COVID-19
Introduction
Pathophysiology of Diabetic Kidney Disease and Effects of COVID-19
Diabetic Kidney Disease
Diagnosis of Diabetic Kidney Disease
Effect of COVID-19 on the Kidney
Acute Kidney Injury and COVID-19
Interplay of COVID-19 and Diabetic Kidney Disease
Impact of Diabetic Kidney Disease Therapies on COVID-19
Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers
Sodium-Glucose Transport Protein 2 Inhibitors
Pathophysiology of Acute Kidney Injury in COVID-19
COVID-19 and Proteinuria
COVID-19 Outcomes in Chronic Kidney Disease
COVID-19 and Kidney Transplantation
Clinical Presentation
Demographic Characteristics, Baseline Comorbidities, and Immunosuppressant Medications in Transplant Patients Hospitalized with COVID-19 Infection
Risk Factors for Adverse Outcomes
Vaccination
Management
Adjustment of Immunosuppression
Conclusion
References
Chapter 6: The Impact of COVID-19 on Diabetic Foot Ulcers
Diabetic Foot Ulcers
Background and Epidemiology
Pathophysiology
Neuropathy
Inflammation
Thrombosis
Management
Screening
Assessment of Contributing Factors and Comorbid Conditions
Wound Care
Treatment of Concomitant Peripheral Arterial Disease
Treatment of Infection
COVID-19 and Diabetic Foot Ulcer Care
Logistical Impact
Pathophysiological Synergy
Triaging Wound Care
Conclusion
References
Chapter 7: Comorbid Obesity and Its Impact on Diabetes and COVID-19
Introduction
Inflammatory Response
Interleukin-6
Tumor Necrosis Factor-α
Angiotensin Pathway
Immune Dysfunction
Hyperglycemia
Interferon-γ
Leptin
Coagulopathy
Clinical Considerations
Respiratory
Long-Term Sequelae
Conclusion
References
Part III: Clinical Management
Chapter 8: Overview of Inpatient Management of Diabetes and COVID-19
Introduction
An Overview of Inpatient Admissions for Diabetes
Diabetes and COVID-19 Requiring Inpatient Admission
Diabetes and Increased Mortality in the Setting of COVID-19
Mortality in Type 1 Versus Type 2 Diabetes
New-Onset Diabetes in Persons with COVID-19
Glycemic Control During Admission
Management of Diabetes and COVID-19
COVID-19 and Oral Agents for Inpatient Diabetes Management
Conclusions
References
Chapter 9: Management of Critically Ill Persons with COVID-19 and Diabetes
Introduction
Hyperglycemia and Diabetes Mellitus in the ICU
Potential Mechanisms of Hyperglycemia by SARS-CoV-2
Stress Hyperglycemia in Critically Ill Patients
Glycemic Targets in the ICU
Hyperglycemia Management in the Critically Ill
Hyperglycemic Emergencies in COVID-19 Disease
Management of Hyperglycemic Emergencies in Critically Ill Patients
Management of Diabetic Ketoacidosis/Hyperosmolar Hyperglycemic State in the Setting of COVID-19 Disease
Subcutaneous Insulin Protocols
Insulin Dosing
Fluid and Electrolyte Management
Glucose Monitoring
Conclusion
References
Chapter 10: Managing Outpatient Diabetes in Persons with COVID-19 and Diabetes
Introduction
Preventing COVID-19 Among Those Not Infected
Vaccinations
Ambulatory Management of Patients with COVID-19
Symptomatic Management
Medical Treatment
Ritonavir-Boosted Nirmatrelvir
Remdesivir
Alternative Options
Non-approved Therapies
Managing Diabetes During COVID-19 Infection
Metformin
SGLT-2 Inhibitors
GLP-1 Receptor Agonists
DPP-4 Inhibitors
Sulfonylureas
Thiazolidinediones
Angiotensin-Converting Enzyme Inhibitors
The Impact of Social Determinants of Health Among Persons with Type 2 Diabetes in the Era of COVID-19
Financial and Food Insecurity
Medication and Glucose Testing Supply Access
Access to Care
Unanswered Questions
Conclusions
References
Chapter 11: The Use of Diabetes Technology in Persons with Diabetes and Coronavirus 2019
Introduction
Diabetes Technology and COVID-19 in the Outpatient Setting
Telehealth/Virtual Clinics
Continuous Glucose Monitoring
Continuous Subcutaneous Insulin Infusion
Diabetes Technology and COVID-19 in the Inpatient Setting
Accuracy of Continuous Glucose Monitoring in the Hospital Setting
Use of CGM in the Inpatient Setting During COVID-19
Telemedicine and Remote Patient Monitoring
Health Disparities and Access to Diabetes Technology During the COVID-19 Pandemic
Conclusion
References
Part IV: Health Outcomes
Chapter 12: COVID-19 Vaccination in Persons with Diabetes: How to Approach Patients
Introduction
General Approach to Vaccination
Duration of Vaccine Response
The Impact of COVID-19 on Hospitalizations and Mortality
Hospitalizations and Mortality in Pregnant Persons with Diabetes
Reasons for Vaccine Hesitancy and Strategies for Increasing Vaccine Confidence
Vaccine Attitudes and Behaviors in People with Diabetes
Strategies to Address Vaccine Skepticism and Build Vaccine Confidence
Conclusion
References
Chapter 13: COVID-19 Vaccination in Persons with Diabetes: How they Work
Introduction
Diabetes and the Immune Response to COVID-19
Vaccination and Immunity Against COVID-19
COVID-19 Vaccination and Diabetes
Immune Response
Complications of COVID-19 Vaccines
Administration of the COVID-19 Vaccine Along with the Routine Vaccines for Patients with Diabetes
Vaccine Prioritization
COVID-19 Vaccine Booster Dose
Summary
References
Chapter 14: Long-Haul COVID Symptoms in Persons with Diabetes
Introduction
Long COVID
Symptoms Associated with Long COVID
Diabetes and Long COVID
Vaccines and Long COVID
Conclusion
References
Index
