About this Research Topic
COVID-19 is a novel, highly transmissible disease which can lead to acute respiratory distress syndrome and multi-organ failure and has already had an unprecedented death toll. Among the risk factors for adverse clinical outcomes, the association between diabetes mellitus and its related co-morbidities and severe COVID-19 disease has been well established. At the same time, this relationship seems to be bidirectional, as stress hyperglycemia during hospitalization, new-onset overt diabetes or an exacerbation of the pre-existing diabetes have been observed in different cohorts. In addition, different antidiabetic medications have been proposed to exert different effects on the severity of the disease by upregulating, for example, the ACE2 receptor expression, while the state of glycemic control per se has always been associated with increased susceptibility to infections. Many questions about the association between COVID-19 disease and diabetes need to be addressed. Firstly, the existing data has shown that not all patients with diabetes have the same increased risk for severe infection; for example, a significantly more robust relationship has been shown for people with type 2 diabetes mellitus. Whether this discrepancy has to do only with the related co-morbidities, such as obesity, hypertension and cardiovascular disease is still a matter of research. In addition, whether stress hyperglycemia is only a temporary reaction to acute disease, or it predisposes to new-onset diabetes after discharge has not yet been determined. The effects of different antidiabetic medications on the disease course have been speculated based mostly on animal and experimental data, and the optimal treatment regimen after recovery is still a matter of debate. The effects of restrictive measures and public health policies on glycemic control and diabetic complications have also been investigates with often inconsistent results.
The scope of this Research Topic is to define the association of COVID-19 and diabetes in terms of: risk factors for adverse clinical outcomes, the rate of stress hyperglycemia and new-onset diabetes during and after COVID-19 infection, the impact of COVID-19 treatment on metabolic control, the possible, if any, effects of antidiabetic medications on disease onset, severity and post-discharge treatment, and the effects of different public health policies on glycemic control and diabetic complications, based on epidemiological data and clinical trials. Original research papers, meta-analyses and systematic reviews which will address these issues are the types of manuscripts which will be prioritized.
Keywords: stress hyperglycemia, COVID-19, diabetes, public health, comorbidities, prevalence, complications, epidemiology, treatment, antidiabetic medication
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