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Diabetes in the time of COVID-19 pandemic: A knife with two sharp ends

Interactions of current pandemic COVID-19 and pre-existing major health burden Diabetes Mellitus have posed a serious global public health crisis. The emergence of COVID-19 as a communicable viral infection along with the presence of non-communicable diabetes, have transformed the health system into a knife with two sharp ends. Though diabetes worldwide is almost 20 times more than COVID-19 positive cases, the severe virulence and pathogenesis coincides with the routine treatment and pathogenesis of diabetes making it one of the most serious comorbid factors. The first three deaths due to COVID-19 reported in China were diabetes patients. The severity of the association of diabetes with COVID-19 ranges from 5 to 20%. Type 1 diabetes mellitus and type 2 diabetes mellitus increase the susceptibility to infections and their complications. The present study was attempted to review probable interaction between these two global health burdens and possible suggestive management to control their detrimental effect. An intensive online search was conducted using two databases, PubMed and Google Scholar. Most hypothesized pathways for COVID-19 infection are the ACE2 receptors and RAAS system followed by the DPP4 receptor pathway. This review proposes that proper and timely management of the COVD-19 patients with diabetes comorbidity might reduce COVID-19 disease burden.