Abstract | The incidence of COVID-19 in DM2 ranged from 10.8-22%. Due to a constant chronic inflammation, as is seen in DM2 patients, they present with increased susceptibility towards SARS-CoV-2 infections. Acute COVID-19 infections are associated with a massive release of pro-inflammatory cytokines and hyperglycemic hormones, which trigger cytokine storms and potential MOF, severe pneumonia, and death. Consequences of long-standing DM2 predispose those patients to pulmonary embolisms, ARDS, sepsis, cardiovascular diseases, heart failure, and AKI, altogether resulting in higher rates of hospitalization, ICU admission, mechanical ventilation, prolonged hospitalization duration, and 2-3-times higher fatal outcomes in comparison to nondiabetic patients. The foremost risk factor for severe outcomes in DM2 patients is glycemic control. During the COVID-19 pandemic, increased incidences of DKA and hyperosmolar hyperglycemic states are detected in conjunction with elevated amylase and lipase levels. Many cases of new-onset hyperglycemia are described, whereby the specific phenotype currently isn´t defined. There is a suspicion that SARS-CoV-2 can rather directly target pancreatic tissue or induce systemic infection resulting in pancreatic -cells apoptosis. For managing COVID-19 in diabetic patients, prevention in terms of optimal glycemic management and a healthy diet is crucial. Based on the individual case, antidiabetic therapy should be carried out using metformin, DPP4is, GLP-1-RA, SGLT2i, and insulin. In new-onset hyperglycemia, insulin in combination with long-term surveillance is the therapy of choice. |