Diabetes & Metabolism Journal

Original Articles

COVID-19
Association of Metabolic Syndrome with COVID-19 in the Republic of Korea: Woo-Hwi Jeon, Jeong-Yeon Seon, So-Youn Park, In-Hwan Oh; Diabetes Metab J. 2022;46(3):427-438. Published online November 26, 2021; DOI: https://doi.org/10.4093/dmj.2021.0105

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Background
Metabolic syndrome (MetS) is reportedly a crucial risk factor for coronavirus disease 2019 (COVID-19). Since the epidemiological studies that examine this association are few and include small samples, we investigated the relationship between MetS and COVID-19 severity and death using a larger sample in the Republic of Korea.
Methods
We analyzed 66,321 patients, 4,066 of whom had COVID-19. We used chi-square tests to examine patients’ characteristics. We performed logistic regression analysis to analyze differences in COVID-19 infection and clinical outcomes according to the presence of MetS.
Results
Although MetS was not significantly associated with COVID-19 risk, acquiring MetS was significantly associated with the risk of severe COVID-19 outcomes (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.34 to 2.91; P=0.001). The mortality risk was significantly higher in COVID-19 patients with MetS (OR, 1.74; 95% CI, 1.17 to 2.59; P=0.006). Patients with abnormal waist circumference were approximately 2.07 times more likely to develop severe COVID-19 (P<0.001), and high-density lipoprotein cholesterol (HDL-C) levels were significantly associated with COVID-19; the mortality risk due to COVID-19 was 1.74 times higher in men with an HDL-C level of <40 mg/dL and in women with an HDL-C level of <50 mg/dL (P=0.012).
Conclusion
COVID-19 is likely associated with severity and death in patients with MetS or in patients with MetS risk factors. Therefore, patients with MetS or those with abnormal waist circumference and HDL-C levels need to be treated with caution.

Citations

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Association between metabolic syndrome and mortality in patients with COVID-19: A nationwide cohort study
Hyo Jin Park, Jin-Hyung Jung, Kyungdo Han, Jean Shin, Yoojeong Lee, Yujin Chang, Kyeyeung Park, Yoon Jeong Cho, Youn Seon Choi, Seon Mee Kim, Ga Eun Nam
Obesity Research & Clinical Practice.2022; 16(6): 484. CrossRef

COVID-19
Impact of COVID-19 Lockdown on the Metabolic Control Parameters in Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis: Ifan Ali Wafa, Nando Reza Pratama, Nurizzah Farahiyah Sofia, Elsha Stephanie Anastasia, Tiffany Konstantin, Maharani Ayuputeri Wijaya, M. Rifqi Wiyono, Lilik Djuari, Hermina Novida; Diabetes Metab J. 2022;46(2):260-272. Published online March 8, 2022; DOI: https://doi.org/10.4093/dmj.2021.0125

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Background
Abrupt implementation of lockdowns during the coronavirus disease 2019 (COVID-19) pandemic affected the management of diabetes mellitus in patients worldwide. Limited access to health facilities and lifestyle changes potentially affected metabolic parameters in patients at risk. We conducted a meta-analysis to determine any differences in the control of metabolic parameters in patients with diabetes, before and during lockdown.
Methods
We performed searches of five databases. Meta-analyses were carried out using random- or fixed-effect approaches to glycaemic control parameters as the primary outcome: glycosylated hemoglobin (HbA1c), random blood glucose (RBG), fasting blood glucose (FBG), time-in-range (TIR), time-above-range (TAR), time-below-range (TBR). Mean difference (MD), confidence interval (CI), and P value were calculated. Lipid profile was a secondary outcome and is presented as a descriptive analysis.
Results
Twenty-one studies enrolling a total of 3,992 patients with type 1 or type 2 diabetes mellitus (T1DM or T2DM) were included in the study. Patients with T1DM showed a significant improvement of TIR and TAR (MD=3.52% [95% CI, 0.29 to 6.74], I²=76%, P=0.03; MD=–3.36% [95% CI, –6.48 to –0.25], I²=75%, P=0.03), while FBG among patients with T2DM significantly worsened (MD=3.47 mg/dL [95% CI, 1.22 to 5.73], I²=0%, P<0.01). No significant difference was found in HbA1c, RBG, and TBR. Use of continuous glucose monitoring in T1DM facilitated good glycaemic control. Significant deterioration of lipid parameters during lockdown, particularly triglyceride, was observed.
Conclusion
Implementation of lockdowns during the COVID-19 pandemic did not worsen glycaemic control in patients with diabetes. Other metabolic parameters improved during lockdown, though lipid parameters, particularly triglyceride, worsened.

Citations

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Glycemic Control in Type 1 Diabetes Mellitus and COVID-19: What We Learned From the Lockdown Experience
Catarina Almeida, André Ferreira, Daniela Duarte, Ana Filipa Viegas, André Santos, Alexandra Vaz, Edite Nascimento
Cureus.2023;[Epub] CrossRef
Changes in body weight and glycemic control in association with COVID-19 Shutdown among 23,000 adults with type 2 diabetes
Emily Panza, Kevin E. Kip, Kripa Venkatakrishnan, Oscar C. Marroquin, Rena R. Wing
Acta Diabetologica.2023; 60(6): 787. CrossRef
The Impact of a Lockdown for the COVID-19 Pandemic on Seasonal HbA1c Variation in Patients with Type 2 Diabetes
Yu-Cheng Cheng, Yu-Hsuan Li, Hsiu-Chen Liu, Chiann-Yi Hsu, Wan-Jen Chang, I-Te Lee, Chin-Li Lu
Life.2023; 13(3): 763. CrossRef
The Impact of Partial Lockdown During COVID-19 Pandemic on Metabolic Control in People with Type 2 Diabetes Mellitus
Ayşe Zülal TOKAÇ, Tuğde Buse UĞUR, Buse Ecem KURUGÖL, Sevilay ALİGÜLÜ, Osman HAYRAN
Journal of Biotechnology and Strategic Health Research.2023; 7(1): 67. CrossRef
Retrospective Study on the Impact of COVID-19 Lockdown on Patients with Type 2 Diabetes in Northern Taiwan
Hsuan Huang, Hsiao-Ling Su, Chih-Hsung Huang, Yi-Hsin Lin
Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 2539. CrossRef
Impact of National Lockdown From COVID-19 Pandemic in Patients With Type 2 Diabetes: An Observational Study
Nuntakorn Thongtang, Niracha Chanwimol, Lukana Preechasuk, Varisara Boonyuang, Pinyo Rattanaumpawan, Supawadee Likitmaskul, Apiradee Sriwijitkamol
Asia Pacific Journal of Public Health.2022; 34(6-7): 708. CrossRef

COVID-19
Effects of Social Distancing on Diabetes Management in Older Adults during COVID-19 Pandemic: Soo Myoung Shin, Tae Jung Oh, Sung Hee Choi, Hak Chul Jang; Diabetes Metab J. 2021;45(5):765-772. Published online August 30, 2021; DOI: https://doi.org/10.4093/dmj.2021.0096

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Background
On March 22, 2020, intense social distancing (SD) was implemented in Korea to prevent the spread of coronavirus disease 19 (COVID-19). This study examined the impact of SD on diabetes control in older adults with diabetes.
Methods
Adults aged 60 to 90 years with type 2 diabetes mellitus who were physically and mentally independent were recruited. Participants who had complete blood chemistry data from April to July 2019 (pre-SD era) and April to July 2020 (SD era) were enrolled. Data were obtained about physical activity, nutrition, sarcopenia, and psychological and mental health from questionnaires in April to July 2020. Calf circumference was measured.
Results
In total, 246 people (100 men, 146 women; mean age, 73.8±5.7 years) participated in this study. The levels of glycated hemoglobin (HbA1c, 7.4%±1.0% vs. 7.1%±0.8%, P<0.001), fasting glucose (142.2±16.7 mg/dL vs. 132.0±27.7 mg/dL, P<0.001), and body weight (62.6±9.4 kg vs. 61.8±10.1 kg, P<0.01) were higher in the SD era than in the pre-SD era. Total physical activity was lower in the SD era (2,584.6±2,624.1 MET-min/week^–1 vs. 1,987.3±2,295.0 MET-min/week^–1, P<0.001). A larger increase in HbA1c level was associated with increased body weight and decreased physical activity.
Conclusion
SD had negative effects on diabetes management in older adults with diabetes. Fasting glucose and HbA1c levels and body weight increased during the SD era. Participants with reduced physical activity gained more weight and had higher blood glucose levels. Given that the COVID-19 pandemic is ongoing, health professionals and diabetes educators should monitor changes in lifestyle factors in older adults with diabetes.

Citations

Citations to this article as recorded by

Obesity and weight change during the COVID‐19 pandemic in children and adults: A systematic review and meta‐analysis
Laura N. Anderson, Yulika Yoshida‐Montezuma, Nora Dewart, Ezza Jalil, Jayati Khattar, Vanessa De Rubeis, Sarah Carsley, Lauren E. Griffith, Lawrence Mbuagbaw
Obesity Reviews.2023;[Epub] CrossRef
Preliminary efficacy of a technology-based physical activity intervention for older Korean adults during the COVID-19 pandemic
Soonhyung Kwon, Oejin Shin, Rosalba Hernandez
Educational Gerontology.2023; : 1. CrossRef
Changes in lifestyle-related behaviour during the COVID-19 pandemic in Japan: a questionnaire survey for examinees who underwent an annual health check-up
Miyako Kishimoto, Kayo Masuko, Sumie Yamamoto, Retsu Fujita, Shoko Nakamura, Masato Odawara, Mikio Zeniya
Journal of International Medical Research.2023;[Epub] CrossRef
Glycaemic monitoring and control among high-risk patients with type 2 diabetes in Australian general practice during COVID-19
Kirrilee Jane Barlow, Paul P Fahey, Evan Atlantis
Family Medicine and Community Health.2023; 11(3): e002271. CrossRef
Stress, Depression, and Unhealthy Behavior Changes among Patients with Diabetes during COVID-19 in Korea
Hae Ran Kim, Jeong-Soon Kim
Healthcare.2022; 10(2): 303. CrossRef
Reply to comment on “Unexpected decline in glycated hemoglobin level after emergency COVID‐19 measures in three robust older Japanese women with prediabetes/mild type 2 diabetes”
Tazuo Okuno, Osamu Iritani, Kumie Kodera, Daisuke Hama, Asami Kane, Kozue Morigaki, Toshio Terai, Norie Maeno, Shigeto Morimoto
Geriatrics & Gerontology International.2022; 22(7): 541. CrossRef
Anxiety, Distress and Stress among Patients with Diabetes during COVID-19 Pandemic: A Systematic Review and Meta-Analysis
Rubén A. García-Lara, José L. Gómez-Urquiza, María José Membrive-Jiménez, Almudena Velando-Soriano, Monserrat E. Granados-Bolivar, José L. Romero-Béjar, Nora Suleiman-Martos
Journal of Personalized Medicine.2022; 12(9): 1412. CrossRef
Prevalence of Depression and Related Factors among Patients with Chronic Disease during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis
Rubén A. García-Lara, Nora Suleiman-Martos, María J. Membrive-Jiménez, Victoria García-Morales, Miguel Quesada-Caballero, Isabel M. Guisado-Requena, José L. Gómez-Urquiza
Diagnostics.2022; 12(12): 3094. CrossRef

COVID-19
Use of Renin-Angiotensin-Aldosterone System Inhibitors and Severe COVID-19 Outcomes in Patients with Hypertension: A Nationwide Cohort Study: Jae Hyun Bae, Sun Kyu Choi, Nam Hoon Kim, Juneyoung Lee, Sin Gon Kim; Diabetes Metab J. 2021;45(3):430-438. Published online February 22, 2021; DOI: https://doi.org/10.4093/dmj.2020.0279

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Background
Angiotensin-converting enzyme 2 facilitates the entry of severe acute respiratory syndrome coronavirus 2 into the human body. We investigated the association of renin-angiotensin-aldosterone system (RAAS) inhibitor use with severe coronavirus disease 2019 (COVID-19) outcomes in hypertensive patients.
Methods
We identified hypertensive patients with confirmed COVID-19 from the Korean Health Insurance Review and Assessment Service from inception to May 15, 2020. The primary outcome was the composite of intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), continuous renal replacement therapy (CRRT), extracorporeal membrane oxygenation (ECMO), and death from COVID-19. The individual components were evaluated as secondary outcomes.
Results
Of 1,374 hypertensive patients with COVID-19, 1,076 (78.3%) and 298 (21.7%) were users and never-users of RAAS inhibitors, respectively. The RAAS inhibitor users were not associated with the risk of the primary outcome (adjusted odds ratio [aOR], 0.72; 95% confidence interval [CI], 0.46 to 1.10). The risk of ICU admission was significantly lower in the users than the never-users (aOR, 0.44; 95% CI, 0.24 to 0.84). The RAAS inhibitors were beneficial only in ICU admissions that did not require IMV (aOR, 0.28; 95% CI, 0.14 to 0.58). The risk of death from COVID-19 was comparable between the groups (aOR, 1.09; 95% CI, 0.64 to 1.85). We could not evaluate the risks of CRRT and ECMO owing to the small number of events.
Conclusion
RAAS inhibitor use was not associated with the composite of severe outcomes in the hypertensive patients with COVID-19 but significantly lowered the risk of ICU admission, particularly in patients who did not require IMV.

Citations

Citations to this article as recorded by

Systematic review and meta-analysis of the clinical outcomes of ACEI/ARB in East-Asian patients with COVID-19
Nancy Xurui Huang, Qi Yuan, Fang Fang, Bryan P. Yan, John E. Sanderson, Masaki Mogi
PLOS ONE.2023; 18(1): e0280280. CrossRef
Renin‐Angiotensin Aldosterone System Inhibitors and COVID‐19: A Systematic Review and Meta‐Analysis Revealing Critical Bias Across a Body of Observational Research
Jordan Loader, Frances C. Taylor, Erik Lampa, Johan Sundström
Journal of the American Heart Association.2022;[Epub] CrossRef
Renin-angiotensin-aldosterone system blockers in Bulgarian COVID-19 patients with or without chronic kidney disease
Rumen Filev, Lionel Rostaing, Mila Lyubomirova, Boris Bogov, Krassimir Kalinov, Dobrin Svinarov
Medicine.2022; 101(48): e31988. CrossRef

COVID-19
Effects of a DPP-4 Inhibitor and RAS Blockade on Clinical Outcomes of Patients with Diabetes and COVID-19: Sang Youl Rhee, Jeongwoo Lee, Hyewon Nam, Dae-Sung Kyoung, Dong Wook Shin, Dae Jung Kim; Diabetes Metab J. 2021;45(2):251-259. Published online March 5, 2021; DOI: https://doi.org/10.4093/dmj.2020.0206

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Background
Dipeptidyl peptidase-4 inhibitor (DPP-4i) and renin-angiotensin system (RAS) blockade are reported to affect the clinical course of coronavirus disease 2019 (COVID-19) in patients with diabetes mellitus (DM).
Methods
As of May 2020, analysis was conducted on all subjects who could confirm their history of claims related to COVID-19 in the National Health Insurance Review and Assessment Service (HIRA) database in Korea. Using this dataset, we compared the short-term prognosis of COVID-19 infection according to the use of DPP-4i and RAS blockade. Additionally, we validated the results using the National Health Insurance Service (NHIS) of Korea dataset.
Results
Totally, data of 67,850 subjects were accessible in the HIRA dataset. Of these, 5,080 were confirmed COVID-19. Among these, 832 subjects with DM were selected for analysis in this study. Among the subjects, 263 (31.6%) and 327 (39.3%) were DPP4i and RAS blockade users, respectively. Thirty-four subjects (4.09%) received intensive care or died. The adjusted odds ratio for severe treatment among DPP-4i users was 0.362 (95% confidence interval [CI], 0.135 to 0.971), and that for RAS blockade users was 0.599 (95% CI, 0.251 to 1.431). These findings were consistent with the analysis based on the NHIS data using 704 final subjects. The adjusted odds ratio for severe treatment among DPP-4i users was 0.303 (95% CI, 0.135 to 0.682), and that for RAS blockade users was 0.811 (95% CI, 0.391 to 1.682).
Conclusion
This study suggests that DPP-4i is significantly associated with a better clinical outcome of patients with COVID-19.

Citations

Citations to this article as recorded by

The Impact of GLP-1 RAs and DPP-4is on Hospitalisation and Mortality in the COVID-19 Era: A Two-Year Observational Study
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DPP-4 Inhibitors as a savior for COVID-19 patients with diabetes
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Risk phenotypes of diabetes and association with COVID-19 severity and death: an update of a living systematic review and meta-analysis
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ACE2, ACE, DPPIV, PREP and CAT L enzymatic activities in COVID-19: imbalance of ACE2/ACE ratio and potential RAAS dysregulation in severe cases
Raquel Leão Neves, Jéssica Branquinho, Júlia Galanakis Arata, Clarissa Azevedo Bittencourt, Caio Perez Gomes, Michelle Riguetti, Gustavo Ferreira da Mata, Danilo Euclides Fernandes, Marcelo Yudi Icimoto, Gianna Mastroianni Kirsztajn, João Bosco Pesquero
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Decreased circulating dipeptidyl peptidase-4 enzyme activity is prognostic for severe outcomes in COVID-19 inpatients
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Ah Reum Khang
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Associations Between the Use of Renin–Angiotensin System Inhibitors and the Risks of Severe COVID-19 and Mortality in COVID-19 Patients With Hypertension: A Meta-Analysis of Observational Studies
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Short Communication

COVID-19
Impact of Social Distancing Due to Coronavirus Disease 2019 on the Changes in Glycosylated Hemoglobin Level in People with Type 2 Diabetes Mellitus: Sung-Don Park, Sung-Woo Kim, Jun Sung Moon, Yin Young Lee, Nan Hee Cho, Ji-Hyun Lee, Jae-Han Jeon, Yeon-Kyung Choi, Mi Kyung Kim, Keun-Gyu Park; Diabetes Metab J. 2021;45(1):109-114. Published online December 4, 2020; DOI: https://doi.org/10.4093/dmj.2020.0226

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19 Citations

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub Crossref - TDM

This study investigated the impact of social distancing due to coronavirus disease 2019 (COVID-19) on glycemic control in people with type 2 diabetes mellitus (T2DM). We retrospectively analyzed the change in glycosylated hemoglobin level (ΔHbA1c) in people with T2DM who undertook social distancing because of COVID-19. We compared the ΔHbA1c between COVID-19 and non-COVID-19 cohorts that were enrolled at the same time of year. The ΔHbA1c of the COVID-19 cohort was significantly higher than that of two non-COVID-19 cohorts. Subgroup analysis according to age and baseline HbA1c level showed that social distancing significantly increased the mean HbA1c level of participants of <50 years. The ΔHbA1c of participants of <50 years and with HbA1c <7.0% in the COVID-19 cohort showed larger changes than other subgroups. In adjusted model, adjusted ΔHbA1c levels in the COVID-19 cohort remained significantly higher than those in the two other cohorts. Social distancing negatively impacts blood glucose control in people with T2DM, especially those who are younger and have good blood glucose control.

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Self-Care of Adults with Type 2 Diabetes During the COVID-19 Pandemic: A Qualitative Interpretive Description Study
Michela Luciani, Camilla Bigoni, Marta Canesi, Matteo Masotto, Diletta Fabrizi, Stefania Di Mauro, Davide Ausili
Clinical Nursing Research.2023; 32(1): 73. CrossRef
Changes in body weight and glycemic control in association with COVID-19 Shutdown among 23,000 adults with type 2 diabetes
Emily Panza, Kevin E. Kip, Kripa Venkatakrishnan, Oscar C. Marroquin, Rena R. Wing
Acta Diabetologica.2023; 60(6): 787. CrossRef
The Impact of a Lockdown for the COVID-19 Pandemic on Seasonal HbA1c Variation in Patients with Type 2 Diabetes
Yu-Cheng Cheng, Yu-Hsuan Li, Hsiu-Chen Liu, Chiann-Yi Hsu, Wan-Jen Chang, I-Te Lee, Chin-Li Lu
Life.2023; 13(3): 763. CrossRef
Changes in the mean incidence and variance of orthopedic diseases before and during the COVID-19 pandemic in Korea: a retrospective study
Joo-Hee Kim, Mi Jung Kwon, Hyo Geun Choi, Sang Jun Lee, Sangwon Hwang, Jaemin Lee, San-Hui Lee, Jung Woo Lee
BMC Musculoskeletal Disorders.2023;[Epub] CrossRef
Gender differences-based bioinformatics analysis to identify hub genes and key pathways in type 2 diabetes
Md Sojib Hossain, Subrina Islam Rupa, Md Sumon Sarkar, Md Al Amin, Mst Tania Khatun, Md Shamim, Md Zahidul Islam
Informatics in Medicine Unlocked.2023; 40: 101302. CrossRef
Retrospective Study on the Impact of COVID-19 Lockdown on Patients with Type 2 Diabetes in Northern Taiwan
Hsuan Huang, Hsiao-Ling Su, Chih-Hsung Huang, Yi-Hsin Lin
Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 2539. CrossRef
Impacts of the COVID-19 pandemic on unmet social needs, self-care, and outcomes among people with diabetes and poor glycemic control
Minal R. Patel, Guanghao Zhang, Cindy Leung, Peter X.K. Song, Michele Heisler, Hae Mi Choe, Roshanak Mehdipanah, Xu Shi, Kenneth Resnicow, Geila Rajaee, John D. Piette
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Impact of the COVID-19 Pandemic on Glycemic Control and Blood Pressure Control in Patients with Diabetes in Japan
Keisuke Endo, Takayuki Miki, Takahito Itoh, Hirofumi Kubo, Ryosuke Ito, Kouhei Ohno, Hiroyuki Hotta, Nobuo Kato, Tomoaki Matsumoto, Aya Kitamura, Mai Tamayama, Takako Wataya, Ayaka Yamaya, Rei Ishikawa, Hitoshi Ooiwa
Internal Medicine.2022; 61(1): 37. CrossRef
The Effects of COVID-19 Lockdown on Glycaemic Control and Lipid Profile in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis
Omorogieva Ojo, Xiao-Hua Wang, Osarhumwese Osaretin Ojo, Edith Orjih, Nivedita Pavithran, Amanda Rodrigues Amorim Adegboye, Qian-Qian Feng, Paul McCrone
International Journal of Environmental Research and Public Health.2022; 19(3): 1095. CrossRef
Lifestyles Under Lockdown: A Scoping Review of International Studies on Type 2 Diabetes Self-Management Behaviors During COVID-19
Caroline Cummings, Kagnica Seng, Ryan Tweet, Julie Wagner
Frontiers in Clinical Diabetes and Healthcare.2022;[Epub] CrossRef
Substitution of telemedicine for clinic visit during the COVID‐19 pandemic of 2020: Comparison of telemedicine and clinic visit
Yukiko Onishi, Rieko Ichihashi, Yoko Yoshida, Tazu Tahara, Takako Kikuchi, Toshiko Kobori, Tetsuya Kubota, Masahiko Iwamoto, Shoko Hamano, Masato Kasuga
Journal of Diabetes Investigation.2022; 13(9): 1617. CrossRef
The impact of the COVID-19 pandemic on the management of patients with chronic diseases in Primary Health Care
Panagiotis Stachteas, Manolis Symvoulakis, Apostolos Tsapas, Emmanouil Smyrnakis
Population Medicine.2022; 4(August): 1. CrossRef
Effects of COVID-19 Pandemic and Lockdown on Monitoring and Treatment Balance of Finnish Coronary Heart Disease and Type 2 Diabetes Patients
Piia Lavikainen, Marja-Leena Lamidi, Teppo Repo, Laura Inglin, Janne Martikainen, Tiina Laatikainen
Clinical Epidemiology.2022; Volume 14: 1363. CrossRef
Impact of Social Distancing Due to Coronavirus Disease 2019 on the Changes in Glycosylated Hemoglobin Level in People with Type 2 Diabetes Mellitus (Diabetes Metab J 2021;45:109-14)
Junghyun Noh
Diabetes & Metabolism Journal.2021; 45(2): 275. CrossRef
Impact of Social Distancing Due to Coronavirus Disease 2019 on the Changes in Glycosylated Hemoglobin Level in People with Type 2 Diabetes Mellitus (Diabetes Metab J 2021;45:109-14)
Sung-Don Park, Sung-Woo Kim, Jun Sung Moon, Jae-Han Jeon, Mi Kyung Kim, Keun-Gyu Park
Diabetes & Metabolism Journal.2021; 45(2): 279. CrossRef
Glucose control in diabetes during home confinement for the first pandemic wave of COVID-19: a meta-analysis of observational studies
Giovanni Antonio Silverii, Chiara Delli Poggi, Ilaria Dicembrini, Matteo Monami, Edoardo Mannucci
Acta Diabetologica.2021; 58(12): 1603. CrossRef
The impact of COVID-19 pandemic on glycemic control in patients with diabetes mellitus in Turkey: a multi-center study from Kocaeli
Alev Selek, Emre Gezer, Eda Altun, Mehmet Sözen, Ömercan Topaloğlu, Damla Köksalan, Halil Demirkan, Dilek Karakaya, Berrin Cetinarslan, Zeynep Cantürk, Dilek Taymez
Journal of Diabetes & Metabolic Disorders.2021; 20(2): 1461. CrossRef
Effects of Social Distancing on Diabetes Management in Older Adults during COVID-19 Pandemic
Soo Myoung Shin, Tae Jung Oh, Sung Hee Choi, Hak Chul Jang
Diabetes & Metabolism Journal.2021; 45(5): 765. CrossRef
Year-Long Trend in Glycated Hemoglobin Levels in Patients with Type 2 Diabetes during the COVID-19 Pandemic
Jonghwa Jin, Seong Wook Lee, Won-Ki Lee, Jae-Han Jeon, Jung-Guk Kim, In-Kyu Lee, Yeon-Kyung Choi, Keun-Gyu Park
Endocrinology and Metabolism.2021; 36(5): 1142. CrossRef

Original Articles

COVID-19
Does Diabetes Increase the Risk of Contracting COVID-19? A Population-Based Study in Korea: Sung-Youn Chun, Dong Wook Kim, Sang Ah Lee, Su Jung Lee, Jung Hyun Chang, Yoon Jung Choi, Seong Woo Kim, Sun Ok Song; Diabetes Metab J. 2020;44(6):897-907. Published online December 23, 2020; DOI: https://doi.org/10.4093/dmj.2020.0199

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Abstract PDF PubReader ePub Crossref - TDM

Background
This study aimed to determine the infection risk of coronavirus disease 2019 (COVID-19) in patients with diabetes (according to treatment method).
Methods
Claimed subjects to the Korean National Health Insurance claims database diagnosed with COVID-19 were included. Ten thousand sixty-nine patients with COVID-19 between January 28 and April 5, 2020, were included. Stratified random sampling of 1:5 was used to select the control group of COVID-19 patients. In total 50,587 subjects were selected as the control group. After deleting the missing values, 60,656 subjects were included.
Results
Adjusted odds ratio (OR) indicated that diabetic insulin users had a higher risk of COVID-19 than subjects without diabetes (OR, 1.25; 95% confidence interval [CI], 1.03 to 1.53; P=0.0278). In the subgroup analysis, infection risk was higher among diabetes male insulin users (OR, 1.42; 95% CI, 1.07 to 1.89), those between 40 and 59 years (OR, 1.66; 95% CI, 1.13 to 2.44). The infection risk was higher in diabetic insulin users with 2 to 4 years of morbidity (OR, 1.744; 95% CI, 1.003 to 3.044).
Conclusion
Some diabetic patients with certain conditions would be associated with a higher risk of acquiring COVID-19, highlighting their need for special attention. Efforts are warranted to ensure that diabetic patients have minimal exposure to the virus. It is important to establish proactive care and screening tests for diabetic patients suspected with COVID-19 for timely disease diagnosis and management.

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Risk factors for SARS-CoV-2 infection during the early stages of the COVID-19 pandemic: a systematic literature review
Matthew Harris, John Hart, Oashe Bhattacharya, Fiona M. Russell
Frontiers in Public Health.2023;[Epub] CrossRef
Diabetes mellitus, maternal adiposity, and insulin-dependent gestational diabetes are associated with COVID-19 in pregnancy: the INTERCOVID study
Brenda Eskenazi, Stephen Rauch, Enrico Iurlaro, Robert B. Gunier, Albertina Rego, Michael G. Gravett, Paolo Ivo Cavoretto, Philippe Deruelle, Perla K. García-May, Mohak Mhatre, Mustapha Ado Usman, Mohamed Elbahnasawy, Saturday Etuk, Raffaele Napolitano, S
American Journal of Obstetrics and Gynecology.2022; 227(1): 74.e1. CrossRef
The Role of Diabetes and Hyperglycemia on COVID-19 Infection Course—A Narrative Review
Evangelia Tzeravini, Eleftherios Stratigakos, Chris Siafarikas, Anastasios Tentolouris, Nikolaos Tentolouris
Frontiers in Clinical Diabetes and Healthcare.2022;[Epub] CrossRef
COVID-19 and Gestational Diabetes: The Role of Nutrition and Pharmacological Intervention in Preventing Adverse Outcomes
Ruben Ramirez Zegarra, Andrea Dall’Asta, Alberto Revelli, Tullio Ghi
Nutrients.2022; 14(17): 3562. CrossRef
A Comprehensive Analysis of Chinese, Japanese, Korean, US-PIMA Indian, and Trinidadian Screening Scores for Diabetes Risk Assessment and Prediction
Norma Latif Fitriyani, Muhammad Syafrudin, Siti Maghfirotul Ulyah, Ganjar Alfian, Syifa Latif Qolbiyani, Muhammad Anshari
Mathematics.2022; 10(21): 4027. CrossRef
The World-Wide Adaptations of Diabetic Management in the Face of COVID-19 and Socioeconomic Disparities: A Scoping Review
Jaafar Abou-Ghaida, Annalia Foster, Sarah Klein, Massah Bassie, Khloe Gu, Chloe Hille, Cody Brown, Michael Daniel, Caitlin Drakeley, Alek Jahnke, Abrar Karim, Omar Altabbakh, Luzan Phillpotts
Cureus.2022;[Epub] CrossRef
Dissection of non-pharmaceutical interventions implemented by Iran, South Korea, and Turkey in the fight against COVID-19 pandemic
Mohammad Keykhaei, Sogol Koolaji, Esmaeil Mohammadi, Reyhaneh Kalantar, Sahar Saeedi Moghaddam, Arya Aminorroaya, Shaghayegh Zokaei, Sina Azadnajafabad, Negar Rezaei, Erfan Ghasemi, Nazila Rezaei, Rosa Haghshenas, Yosef Farzi, Sina Rashedi, Bagher Larijan
Journal of Diabetes & Metabolic Disorders.2021; 20(2): 1919. CrossRef

COVID-19
Independent Impact of Diabetes on the Severity of Coronavirus Disease 2019 in 5,307 Patients in South Korea: A Nationwide Cohort Study: Sun Joon Moon, Eun-Jung Rhee, Jin-Hyung Jung, Kyung-Do Han, Sung-Rae Kim, Won-Young Lee, Kun-Ho Yoon; Diabetes Metab J. 2020;44(5):737-746. Published online October 21, 2020; DOI: https://doi.org/10.4093/dmj.2020.0141

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Abstract PDF Supplementary Material PubReader ePub Crossref - TDM

Background
Inconsistent results have been observed regarding the independent effect of diabetes on the severity of coronavirus disease 2019 (COVID-19). We conducted a nationwide population-based cohort study to evaluate the relationship between diabetes and COVID-19 severity in South Korea.
Methods
Patients with laboratory-confirmed COVID-19 aged ≥30 years were enrolled and medical claims data were obtained from the Korean Health Insurance Review and Assessment Service. Hospitalization, oxygen treatment, ventilator application, and mortality were assessed as severity outcomes. Multivariate logistic regression analyses were performed after adjusting for age, sex, and comorbidities.
Results
Of 5,307 COVID-19 patients, the mean age was 56.0±14.4 years, 2,043 (38.5%) were male, and 770 (14.5%) had diabetes. The number of patients who were hospitalized, who received oxygen, who required ventilator support, and who died was 4,986 (94.0%), 884 (16.7%), 121 (2.3%), and 211 (4.0%), respectively. The proportion of patients with diabetes in the abovementioned outcome groups was 14.7%, 28.1%, 41.3%, 44.6%, showing an increasing trend according to outcome severity. In multivariate analyses, diabetes was associated with worse outcomes, with an adjusted odds ratio (aOR) of 1.349 (95% confidence interval [CI], 1.099 to 1.656; P=0.004) for oxygen treatment, an aOR of 1.930 (95% CI, 1.276 to 2.915; P<0.001) for ventilator use, and an aOR of 2.659 (95% CI, 1.896 to 3.729; P<0.001) for mortality.
Conclusion
Diabetes was associated with worse clinical outcomes in Korean patients with COVID-19, independent of other comorbidities. Therefore, patients with diabetes and COVID-19 should be treated with caution.

Citations

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Impact of COVID-19 on the Microbiome and Inflammatory Status of Type 2 Diabetes Patients
Gratiela Gradisteanu Pircalabioru, Georgiana Alexandra Grigore, Ilda Czobor Barbu, Mariana-Carmen Chifiriuc, Octavian Savu
Biomedicines.2023; 11(1): 179. CrossRef
Bidirectional Relationship between Glycemic Control and COVID-19 and Perspectives of Islet Organoid Models of SARS-CoV-2 Infection
Tongran Zhang, Nannan Wang, Lingqiang Zhu, Lihua Chen, Huisheng Liu
Biomedicines.2023; 11(3): 856. CrossRef
Screening, diagnosis and management of diabetic sensorimotor polyneuropathy in clinical practice: International expert consensus recommendations
Dan Ziegler, Solomon Tesfaye, Vincenza Spallone, Irina Gurieva, Juma Al Kaabi, Boris Mankovsky, Emil Martinka, Gabriela Radulian, Khue Thy Nguyen, Alin O Stirban, Tsvetalina Tankova, Tamás Varkonyi, Roy Freeman, Péter Kempler, Andrew JM Boulton
Diabetes Research and Clinical Practice.2022; 186: 109063. CrossRef
The Role of Diabetes and Hyperglycemia on COVID-19 Infection Course—A Narrative Review
Evangelia Tzeravini, Eleftherios Stratigakos, Chris Siafarikas, Anastasios Tentolouris, Nikolaos Tentolouris
Frontiers in Clinical Diabetes and Healthcare.2022;[Epub] CrossRef
The interrelationship between diabetes mellitus and COVID-19
ThekraAbdulaali Abed, ZainabAdil Ghani Chabuck
Medical Journal of Babylon.2022; 19(1): 1. CrossRef
Impact of Type 2 Diabetes Mellitus on the Incidence and Outcomes of COVID-19 Needing Hospital Admission According to Sex: Retrospective Cohort Study Using Hospital Discharge Data in Spain, Year 2020
Jose M. de Miguel-Yanes, Rodrigo Jimenez-Garcia, Javier de Miguel-Diez, Valentin Hernández-Barrera, David Carabantes-Alarcon, Jose J. Zamorano-Leon, Ricardo Omaña-Palanco, Ana Lopez-de-Andres
Journal of Clinical Medicine.2022; 11(9): 2654. CrossRef
Diabetes Fact Sheet in Korea 2021
Jae Hyun Bae, Kyung-Do Han, Seung-Hyun Ko, Ye Seul Yang, Jong Han Choi, Kyung Mook Choi, Hyuk-Sang Kwon, Kyu Chang Won
Diabetes & Metabolism Journal.2022; 46(3): 417. CrossRef
The burden and risks of emerging complications of diabetes mellitus
Dunya Tomic, Jonathan E. Shaw, Dianna J. Magliano
Nature Reviews Endocrinology.2022; 18(9): 525. CrossRef
Clinical Characteristics and Outcomes of Patients Hospitalized with COVID-19 at Case Hospital, Uganda
Mirriam Apiyo, Ronald Olum, Amina Kabuye, Betty Khainza, Anne M. Amate, Vittal Byabashaija, Derrick Nomujuni, Kato Sebbaale, Peter Senfuka, Simon Kazibwe, Gurav Sharma, Lindsay Davidson, Felix Bongomin, Diamantis Kofteridis
Interdisciplinary Perspectives on Infectious Diseases.2022; 2022: 1. CrossRef
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Daniel J. Drucker
Cell Metabolism.2021; 33(3): 479. CrossRef
Effects of a DPP-4 Inhibitor and RAS Blockade on Clinical Outcomes of Patients with Diabetes and COVID-19
Sang Youl Rhee, Jeongwoo Lee, Hyewon Nam, Dae-Sung Kyoung, Dong Wook Shin, Dae Jung Kim
Diabetes & Metabolism Journal.2021; 45(2): 251. CrossRef
COVID-19 vaccine acceptance among high-risk populations in Uganda
Felix Bongomin, Ronald Olum, Irene Andia-Biraro, Frederick Nelson Nakwagala, Khalid Hudow Hassan, Dianah Rhoda Nassozi, Mark Kaddumukasa, Pauline Byakika-Kibwika, Sarah Kiguli, Bruce J. Kirenga
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Irene Stulin, Maria Montes de Oca, Gabriela Blanco, Laura Sánchez, Isabel-Carlota Silva, Jennireth Quevedo, Maria Cristina Arvelo, Nathalia Valera, Irene Papa, Hospital Centro Médico de Caracas, Caracas, Venezuela Bacci, Fátima de Abreu, Héctor Villarroel
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Cheol Ryong Ku, Kyong Yeun Jung, Chang Ho Ahn, Jun Sung Moon, Ju Hee Lee, Eun Heui Kim, Hyemi Kwon, Hee Kyung Kim, Sunghwan Suh, Sangmo Hong, Jeonghoon Ha, Eun Roh, Jin Hwa Kim, Mi-kyung Kim
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Diabetes Mellitus and COVID-19: Review Article
Mahmoud Nassar, Ahmed Daoud, Nso Nso, Luis Medina, Victoria Ghernautan, Harangad Bhangoo, Andrew Nyein, Mahmoud Mohamed, Ahmed Alqassieh, Karim Soliman, Mostafa Alfishawy, Issac Sachmechi, Anoop Misra
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2021; 15(6): 102268. CrossRef
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Journal of Diabetes & Metabolic Disorders.2021; 20(2): 1919. CrossRef
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Puneeta Gupta, Meeta Gupta, Neena KAtoch, Ketan Garg, Bhawna Garg
International Journal of Endocrinology and Metabolism.2021;[Epub] CrossRef
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Sang Youl Rhee
The Journal of Korean Diabetes.2021; 22(3): 174. CrossRef
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Yahya Mahamat-Saleh, Thibault Fiolet, Mathieu Edouard Rebeaud, Matthieu Mulot, Anthony Guihur, Douae El Fatouhi, Nasser Laouali, Nathan Peiffer-Smadja, Dagfinn Aune, Gianluca Severi
BMJ Open.2021; 11(10): e052777. CrossRef
Independent Impact of Diabetes on the Severity of Coronavirus Disease 2019 in 5,307 Patients in South Korea: A Nationwide-Cohort Study (Diabetes Metab J 2020;44:737-46)
Kyuho Kim, Tae Jung Oh
Diabetes & Metabolism Journal.2020; 44(6): 938. CrossRef

Covid-19
The Clinical Characteristics and Outcomes of Patients with Moderate-to-Severe Coronavirus Disease 2019 Infection and Diabetes in Daegu, South Korea: Mi Kyung Kim, Jae-Han Jeon, Sung-Woo Kim, Jun Sung Moon, Nan Hee Cho, Eugene Han, Ji Hong You, Ji Yeon Lee, Miri Hyun, Jae Seok Park, Yong Shik Kwon, Yeon-Kyung Choi, Ki Tae Kwon, Shin Yup Lee, Eon Ju Jeon, Jin-Woo Kim, Hyo-Lim Hong, Hyun Hee Kwon, Chi Young Jung, Yin Young Lee, Eunyeoung Ha, Seung Min Chung, Jian Hur, June Hong Ahn, Na-young Kim, Shin-Woo Kim, Hyun Ha Chang, Yong Hoon Lee, Jaehee Lee, Keun-Gyu Park, Hyun Ah Kim, Ji-Hyun Lee; Diabetes Metab J. 2020;44(4):602-613. Published online August 12, 2020; DOI: https://doi.org/10.4093/dmj.2020.0146

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Abstract PDF Supplementary Material PubReader ePub Crossref - TDM

Background

Coronavirus disease 2019 (COVID-19) is a global pandemic that had affected more than eight million people worldwide by June 2020. Given the importance of the presence of diabetes mellitus (DM) for host immunity, we retrospectively evaluated the clinical characteristics and outcomes of moderate-to-severe COVID-19 in patients with diabetes.

Methods

We conducted a multi-center observational study of 1,082 adult inpatients (aged ≥18 years) who were admitted to one of five university hospitals in Daegu because of the severity of their COVID-19-related disease. The demographic, laboratory, and radiologic findings, and the mortality, prevalence of severe disease, and duration of quarantine were compared between patients with and without DM. In addition, 1:1 propensity score (PS)-matching was conducted with the DM group.

Results

Compared with the non-DM group (n=847), patients with DM (n=235) were older, exhibited higher mortality, and required more intensive care. Even after PS-matching, patients with DM exhibited more severe disease, and DM remained a prognostic factor for higher mortality (hazard ratio, 2.40; 95% confidence interval, 1.38 to 4.15). Subgroup analysis revealed that the presence of DM was associated with higher mortality, especially in older people (≥70 years old). Prior use of a dipeptidyl peptidase-4 inhibitor or a renin-angiotensin system inhibitor did not affect mortality or the clinical severity of the disease.

Conclusion

DM is a significant risk factor for COVID-19 severity and mortality. Our findings imply that COVID-19 patients with DM, especially if elderly, require special attention and prompt intensive care.

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Review

Complications
Coronavirus Disease 2019 and Diabetes: The Epidemic and the Korean Diabetes Association Perspective: Junghyun Noh, Hyun-Ha Chang, In-Kyung Jeong, Kun Ho Yoon; Diabetes Metab J. 2020;44(3):372-381. Published online June 29, 2020; DOI: https://doi.org/10.4093/dmj.2020.0138

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14 Citations

Abstract PDF PubReader Crossref - TDM

Diabetes has been associated with more severe outcomes and higher mortality in coronavirus disease 2019 (COVID-19) patients compare to morbidity and mortality in patients without diabetes. Several mechanisms may play a role in this greater morbidity and mortality, especially uncontrolled hyperglycemia, an impaired immune system, pre-existing proinflammatory states, multiple comorbidities, and dysregulated angiotensin-converting enzyme 2 signaling. Thus, the diabetes medical community emergently needs to know about COVID-19 and its effects on patients with diabetes, as they must take precautions to carefully manage these patients during the COVID-19 pandemic. The Korean Diabetes Association provides some guidance and practical recommendations for the management of diabetes during the pandemic. This report provides insight into the association between diabetes and COVID-19, proper management of diabetes in patients with COVID-19 and an official suggestion by the Korean Diabetes Association for managing the COVID-19 outbreak.

Citations

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Original Article

Complications
The Risk of Diabetes on Clinical Outcomes in Patients with Coronavirus Disease 2019: A Retrospective Cohort Study: Seung Min Chung, Yin Young Lee, Eunyeong Ha, Ji Sung Yoon, Kyu Chang Won, Hyoung Woo Lee, Jian Hur, Kyung Soo Hong, Jong Geol Jang, Hyun Jung Jin, Eun Young Choi, Kyeong-Cheol Shin, Jin Hong Chung, Kwan Ho Lee, June Hong Ahn, Jun Sung Moon; Diabetes Metab J. 2020;44(3):405-413. Published online May 21, 2020; DOI: https://doi.org/10.4093/dmj.2020.0105

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Abstract PDF Supplementary Material PubReader Crossref - TDM

Background

To determine the role of diabetes mellitus (DM) in the coronavirus disease 2019 (COVID-19), we explored the clinical characteristics of patients with DM and compared risk factors such as age, glycemic control, and medications to those without DM.

Methods

This was a retrospective cohort study of 117 confirmed patients with COVID-19 which conducted at a tertiary hospital in Daegu, South Korea. The primary outcome was defined as the severe and critical outcome (SCO), of which the composite outcomes of acute respiratory distress syndrome, septic shock, intensive care unit care, and 28-day mortality. We analyzed what clinical features and glycemic control-related factors affect the prognosis of COVID-19 in the DM group.

Results

After exclusion, 110 participants were finally included. DM patients (n=29) was older, and showed higher blood pressure compared to non-DM patients. DM group showed higher levels of inflammation-related biomarkers and severity score, and highly progressed to SCO. After adjustment with other risk factors, DM increased the risk of SCO (odds ratio [OR], 10.771; P<0.001). Among the DM patients, SCO was more prevalent in elderly patients of ≥70 years old and age was an independent risk factor for SCO in patients with DM (OR, 1.175; P=0.014), while glycemic control was not. The use of medication did not affect the SCO, but the renin-angiotensin system inhibitors showed protective effects against acute cardiac injury (OR, 0.048; P=0.045).

Conclusion

The COVID-19 patients with DM had higher severity and resulted in SCO. Intensive and aggressive monitoring of COVID-19 clinical outcomes in DM group, especially in elderly patients is warranted.

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Special Editorial

COVID-19
The Outbreak of COVID-19 and Diabetes in Korea: “We Will Find a Way as We Have Always Done”: Kyu Chang Won, Kun Ho Yoon; Diabetes Metab J. 2020;44(2):211-212. Published online April 23, 2020; DOI: https://doi.org/10.4093/dmj.2020.0092

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Brief Report

Complications
Acute Hyperglycemic Crises with Coronavirus Disease-19: Case Reports: Na-young Kim, Eunyeong Ha, Jun Sung Moon, Yong-Hoon Lee, Eun Young Choi; Diabetes Metab J. 2020;44(2):349-353. Published online April 23, 2020; DOI: https://doi.org/10.4093/dmj.2020.0091

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Since the first case was contracted by coronavirus disease-19 (COVID-19) in Daegu, Korea in February 2020, about 6,800 cases and 130 deaths have been reported on April 9, 2020. Recent studies have reported that patients with diabetes showed higher mortality and they had a worse prognosis than the group without diabetes. In poorly controlled patients with diabetes, acute hyperglycemic crises such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) also might be precipitated by COVID-19. Thus, intensive monitoring and aggressive supportive care should be needed to inadequately controlled patients with diabetes and COVID-19 infection. Here, we report two cases of severe COVID-19 patients with acute hyperglycemic crises in Korea.

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SARS-CoV-2 Cell Entry Factors ACE2 and TMPRSS2 Are Expressed in the Microvasculature and Ducts of Human Pancreas but Are Not Enriched in β Cells
Katie C. Coate, Jeeyeon Cha, Shristi Shrestha, Wenliang Wang, Luciana Mateus Gonçalves, Joana Almaça, Meghan E. Kapp, Maria Fasolino, Ashleigh Morgan, Chunhua Dai, Diane C. Saunders, Rita Bottino, Radhika Aramandla, Regina Jenkins, Roland Stein, Klaus H.
Cell Metabolism.2020; 32(6): 1028. CrossRef
Caring for Hospitalized Patients with Diabetes Mellitus, Hyperglycemia, and COVID-19: Bridging the Remaining Knowledge Gaps
Amisha Wallia, Grace Prince, Emilie Touma, Malek El Muayed, Jane Jeffrie Seley
Current Diabetes Reports.2020;[Epub] CrossRef
Recovery From Acute Kidney Injury With Diabetic Ketoacidosis Following SARS-CoV-2 Infection: A Case Report and Literature Review
Chang Xu, Umer Zia
Cureus.2020;[Epub] CrossRef
The Outbreak of COVID-19 and Diabetes in Korea: “We Will Find a Way as We Have Always Done”
Kyu Chang Won, Kun Ho Yoon
Diabetes & Metabolism Journal.2020; 44(2): 211. CrossRef

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COVID-19 in DMJ