Hypoglycemia in patients with COVID-19: risk factors and prevention of complications

Abstract

The aim of the work is to analyze the available scientific information and generalize the main results of modern research on the causes and risk factors of hypoglycemia in patients with COVID-19. Materials and methods. A search and analysis of full-text articles was carried out in the PubMed, Web of Science, Google Scholar, and Scopus databases. The search was conducted using the key terms: COVID-19 and hypoglycemia, hypoglycemia in COVID-19 patients and treatment of COVID-19 and hypoglycemia from the beginning of the pandemic in December 2019 to July 1, 2022. Results. The analysis of literary sources made it possible to identify three groups of factors that lead to the occurrence of hypoglycemia in patients with COVID-19: peculiarities of the diabetes course in patients with COVID-19 and the influence of concomitant diseases, side effects of certain groups of drugs and methods of therapy and prevention; shortcomings in the organization of treatment and patient care. Hypoglycemia has been shown to be a risk factor for cardiovascular and total mortality in patients with diabetes, may trigger the development of a cytokine storm during COVID-19 disease, and negatively impact mortality and length of hospital stay in COVID-19. Conclusions. To prevent hypoglycemic states in patients, one should avoid sudden changes in the type and dose of hypoglycemic drugs, periodically monitor the HbA1c level, expand the reach of patients with virtual consultations and telemedicine programs. In the case of determining the program of treatment and vaccination against COVID-19 in patients with diabetes mellitus, the known and possible hypoglycemic effects of drugs and vaccines should be taken into account.