Diabetes mellitus in combination with COVID-19: modern views on therapy





COVID-19, angiotensin-converting enzyme 2, diabetes mellitus


Diabetic patients are in the spotlight from the early stages of a pandemic, as growing epidemiological data show they are at higher risk for severe clinical outcomes from COVID-19. As the global COVID-19 pandemic continues to evolve, it is also becoming increasingly apparent that the interactions between COVID-19 and diabetes mellitus (DM) are complex pathophysiological mechanisms. The outcome of COVID-19 is more severe in people with DM, which has the potential to accelerate the onset of acute metabolic complications of DM such as diabetic ketoacidosis and hyperglycemia. These mechanisms underlying these associations remain unclear, but they likely include the angiotensin converting enzyme receptor 2, a binding site for SARS-CoV-2, which is expressed in key metabolic organs such as in the pancreas, in particular in β-cells. The potential β-cell tropism of SARS-CoV-2 can damage cells and impair insulin secretion, causing hyperglycemia and ketoacidosis. Understanding the bidirectional interaction between DM and COVID-19 will be critical to protecting and treating people with DM. Current epidemiological data on COVID-19 do not support the hypothesis that diabetic patients are at increased risk of infection compared to the general population. To date, it has been established that decompensated DM is an independent factor that aggravates the course of coronavirus infection and significantly increases the risk of a fatal outcome of the disease.
The review provides a brief summary of the evolution of pathogenetic and clinical aspects for understanding the mechanisms of this pathological tandem, as well as therapeutic strategies for treating patients with COVID-19 and DM. As the incidence of DM continues to rise globally, more than ever, diabetes prevention and control must be a priority for health systems around the world.

Author Biographies

V.I. Tsymbaliuk, NAMS of Ukraine

MD, professor, president of the NAMS of Ukraine, academician of the NAMS of Ukraine, corresponding member of the NAS of Ukraine

M.D. Tronko, NAMS of Ukraine; SI “V.P. Komisarenko Institute of Endocrinology and Metabolism of the NAMS of Ukraine”

MD, professor, vice-president of the NAMS of Ukraine, academician of the NAMS of Ukraine, corresponding member of the NAS of Ukraine;


Y.G. Antypkin, NAMS of Ukraine; SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”

MD, professor, academician of the NAMS of Ukraine, academician-secretary of the Clinical Medicine Department of the NAMS of Ukraine;


S.V. Kushnirenko, Shupyk National Healthcare University of Ukraine

MD, associate professor, Department of nephrology and renal replacement therapy, dean of Therapeutic Faculty

V.V. Popova, SI “V.P. Komisarenko Institute of Endocrinology and Metabolism of the NAMS of Ukraine”

MD, head of the Department of Preventive Diabetology


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How to Cite

Tsymbaliuk, V., Tronko, M. ., Antypkin, Y., Kushnirenko, S., & Popova, V. (2021). Diabetes mellitus in combination with COVID-19: modern views on therapy. REPRODUCTIVE ENDOCRINOLOGY, (57), 8–20. https://doi.org/10.18370/2309-4117.2021.57.8-20



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