Insulin resistance in COVID-19 and diabetes

Highlights

• Risk of mortality increases in patients with diabetes and COVID-19.

• COVID-19 infection decreases ACE2 expression and increases Ang II activity.

• Insulin resistance ensues with a higher immune effect and severe COVID-19 infection.

Abstract

Background

The epidemiology of COVID-19 and its association with cardiometabolic disorders is poorly understood. This is a narrative review that investigates the effects of COVID-19 infection on insulin resistance in patients with diabetes.

Methods

An online search of all published literature was done via PubMed and Google Scholar using the MeSH terms “COVID-19,” “SARS-CoV-2,” “coronavirus,” “insulin resistance,” and “diabetes.” Only articles that were directly applicable to insulin resistance in COVID-19 and diabetes was reviewed.

Results

Current data shows an increased risk of mortality in patients with diabetes and COVID-19 compared to those without diabetes. COVID-19 triggers insulin resistance in patients, causing chronic metabolic disorders that were non-existent prior to infection.

Conclusion

Patients with diabetes are more susceptible to COVID-19 infection than those without diabetes. ACE2 expression decreases with infection, exaggerating Ang II activity with subsequent insulin resistance development, an exaggerated immune response and severe SARS-COV-2 infection.