Our reporter Ma Aiping

  What is the relationship between diabetes and new coronary pneumonia?

  Recently, in a letter published in the New England Journal of Medicine, an international team of 17 diabetes experts said that new coronary pneumonia may cause diabetes in healthy people and lead to serious complications in patients with diabetes.

  A few days ago, an international expert group composed of 20 top experts in the field of diabetes and endocrinology, including the director of the Department of Endocrinology of Peking University People’s Hospital and the director of Peking University Diabetes Center, published the new model in The Lancet Practical recommendations for the management of patients with coronavirus infection and diabetes" (hereinafter referred to as "recommendations"). According to the paper, elderly diabetes patients with new coronary pneumonia have a higher risk of dying from the disease. At the same time, the new coronavirus may actually promote normal people to become new-onset diabetic patients.

  These studies not only issued a warning to patients with new coronary pneumonia and diabetes, but also sounded the alarm for ordinary diabetic patients and even healthy people.

New coronavirus "preferred" diabetic patients

  "Experts have found that in many countries, a considerable proportion of people infected with new crown virus are diabetic patients, and once these diabetic patients have new coronary pneumonia, the risk of entering the intensive care unit and dying is extremely high." Ji Linong In an interview with a reporter from Science and Technology Daily.

  Among patients diagnosed with new coronary pneumonia worldwide, researchers have found that 20% to 50% of patients have diabetes, proving that diabetes is one of the underlying diseases closely related to the severity of new coronary pneumonia infection. Epidemiological observations in areas where New Coronavirus is severely infected and reports from some national health centers and hospitals show that patients with diabetes have a risk of dying of New Coronary Pneumonia more than 50% higher than those without diabetes.

  Why are there so many patients with diabetes associated with new coronary pneumonia? Ji Linong explained that this is because patients with diabetes are in a state of high blood sugar for a long time, and the body's ability to defend against infection is low, and the risk of infection of the virus will increase. At the same time, patients with New Coronary Pneumonia and Diabetes are more likely to have increased blood glucose and large fluctuations in blood sugar; and the elderly have a high prevalence of type 2 diabetes and many comorbidities such as cardiovascular disease. One of the reasons for the high.

May induce new diabetes in normal people

  "From the current understanding of the new coronavirus, it does not have a very strong seasonality like the SARS virus. If the prevention is not strengthened, there may be a risk of outbreaks. Therefore, both diabetic patients and the general population should pay more attention Prevention of the new coronavirus." Ji Linong said.

  "Recommendation" mentioned that although it has not been confirmed that the new coronavirus will induce diabetes, but there is evidence that the new coronavirus infection may be a factor that induces diabetes.

  According to experts, the combination strength of the new coronavirus and ACE2 (angiotensin-converting enzyme 2, which is expressed in airway epithelial cells, intestinal tract and pancreas, etc., and was previously used as a receptor for the invasion of new coronavirus cells) is very strong. Infection can aggravate the increase in blood glucose and metabolic abnormalities in diabetic patients through more active ACE2 receptors, and the potential pancreatic β-cell damage caused by the virus leads to insulin deficiency. The new crown virus infection not only aggravates the condition of diabetic patients, but may also induce normal people New onset diabetes.

  Clinically, some patients with new coronary pneumonia have used glucocorticoids, and glucocorticoid therapy often causes blood sugar fluctuations. If glucocorticoid treatment is used for a long time, the risk of diabetes will increase by 36%-131%.

Strengthening blood sugar management is the best defense

  In the new crown epidemic, the treatment and management of chronic diseases, mainly diabetes, are challenged. According to statistics, the number of patients with diabetes in China has reached 130 million. There is one diabetes patient in every 10 people, but the blood sugar control situation of diabetic patients is not optimistic.

  For patients with diabetes or hyperglycemia in new coronary pneumonia, Ji Linong said that controlling high blood glucose can not only reduce the risk of acute complications of diabetes, but also improve the overall prognosis of new coronary pneumonia. "Good blood glucose control and management is essential to reduce patient mortality and infections," he emphasized.

  "Diabetic patients should strengthen blood glucose and metabolic management, which is an important first-level prevention method; at the same time, different patients should carry out individualized target management, lifestyle intervention, blood glucose monitoring and corresponding drug treatment. For patients with new coronary pneumonia and diabetes To strictly control blood sugar and improve the prognosis of patients without increasing the risk of hypoglycemia. Insulin has no gastrointestinal side effects, obvious hypoglycemic effect, is beneficial to tissue repair, the dosage can be adjusted in time, and is not contraindicated for liver and kidney function And other advantages, should be used as the first choice of treatment drugs." Ji Linong said.

  Experts said that for diabetics, strict control of blood sugar, balanced diet and reasonable work and rest, and maintaining a happy mood are the best defenses against new coronavirus; at the same time, in the context of normalization of epidemic prevention and control, it is necessary to do a good job The management and prevention of diabetes, early diagnosis and early treatment, control the occurrence and development speed of diabetes and its complications, and strengthen the construction of diabetes prevention and control mechanism.