In general, people with diabetes are more likely to have more severe symptoms and complications when infected with any pathogen. Like incase of Covid-19 infection, people with diabetes are having major complications & less recovery rate. According to Sciencedirect the mortality rate (27.7%) is higher in Covid-19 patients with diabetes.Diabetic patients have more chance to become ill due to Mucormycosis infection.
But why so?
Let’s start from the basic.
What is diabetes? What are the major problems seen in diabetic patients?
Definition: Diabetes is a metabolic disease that occurs when your blood glucose, also called blood sugar, is too high.
Insulin, is a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy & thus it maintain the glucose level in the circulation. Learn more about diabetes
What are the major Changes occurs in a Diabetic Patient:
In patients with diabetes,uncontrolled hyperglycemia leads to multiple complications like vascular disease,immune dysfunction,Neuropathy,Cardiomyopathy,Diabetic retinopathy,Diabetic nephropathy etc.
Vascular Disease:
As we age fat, cholesterol, calcium, and other substances deposits inside our arteries & forms a plaque.Over time, plaque hardens and narrows our arteries. But high glucose levels disturb the micro-environment of arteries, and when out of balance, blood vessels can stiffen and narrow at an accelerated rate. This limits the flow of oxygen-rich blood to cells,thus the cells aren’t functioning properly.
Mechanism:
- Glycosylation of serum and tissue proteins with formation of advanced glycosylation end products.
- Superoxide production
- Activation of protein kinase C, a signaling molecule that increases vascular permeability and causes endothelial dysfunction
- Accelerated hexosamine biosynthetic and polyol pathways leading to sorbitol accumulation within tissues
- Hypertension
- Arterial microthromboses
- Proinflammatory and prothrombotic effects of hyperglycemia and hyperinsulinemia that impair vascular autoregulation
It may have different effects–
A.Microvascular diseases: Microvascular disease may also impair skin healing, so that even minor breaks in skin integrity can develop into deeper ulcers and easily become infected, particularly in the lower extremities.
Retinopahy: Diabetic retinopathy is the most common cause of adult blindness
Nephropathy:
Neuropathy:
B.Macrovascular diseases: It involves atherosclerosis of large vessels.Large-vessel atherosclerosis is a result of the hyperinsulinemia, dyslipidemias, and hyperglycemia characteristic of diabetes mellitus.
Angina pectoris:
Cardiomyopathy: It may be due to epicardial atherosclerosis,hypertension & left ventricular hypertrophy.
Myocardial infarction:
Transient ischemic attack & strokes
Peripheral arterial disease