SARS-CoV-2 is known to utilize angiotensin-converting enzyme 2 (ACE2) receptors for entry into target cells. Insulin administration attenuates ACE2 expression, while hypoglycemic agents (eg, glucagonlike peptide 1 [GLP-1] agonists, thiazolidinediones) up-regulate ACE2. Dipeptidyl peptidase 4 (DPP-4) is highly involved in glucose and insulin metabolism, as well as in immune regulation. This protein was shown to be a functional receptor for Middle East respiratory syndrome coronavirus (MERS-CoV), and protein modeling suggests that it may play a similar role with SARS-CoV-2, the virus responsible for COVID-19.
Please have a look at this useful RG link.
Article COVID-19 and diabetes: Knowledge in progress
Please also see the links below.
https://www.cebm.net/covid-19/diabetes-and-risks-from-covid-19/
https://www.medscape.com/answers/2500114-197420/why-is-diabetes-a-risk-factor-for-coronavirus-disease-2019-covid-19
Diabetes is a risk factor for coronavirus disease, causes are multifactorial:
Viral infection may cause a sharp fluctuation of the blood glucose level of diabetes patients, which adversely affect the recovery of patients, there is a reason to suspect that diabetes combined with SARS-CoV-2pneumonia may form a vicious circle, which is detrimental to the prognosis of COVID-19.
In diabetic patients, biochemical results showed that some indicative enzymes were abnormally elevated in the blood of patients with SARS-CoV-2 pneumonia, including LDH, HBDH, ALT and GGT, which indicated the injury of myocardium, kidney and liver and it is opined that injury of organs was much more serious in diabetes patients group than those without diabetes.
Furthermore, the serum levels of some inflammation-related biomarkers are much higher compared to those without diabetes, such as IL-6, serum ferritin, ESR and CRP.
Article Diabetes is a risk factor for the progression and prognosis ...
People with diabetes most likely have compromised immune system and as such have high risk of contracting Covid-19 infection.
This article of medscape answers why diabetes is a risk factor for COVID-19 with increased morbidity and mortality.
Why is diabetes a risk factor for coronavirus disease 2019 (COVID-19)?
https://www.medscape.com/answers/2500114-197420/why-is-diabetes-a-risk-factor-for-coronavirus-disease-2019-covid-19
Ethnicity and COVID-19: Diabetics in a UK study more likely to be admitted in the ICU with higher mortality
In a study of COVID-19 in the United Kingdom, Ethnic minorities, mainly from South Asia, had higher rates of diabetes and were more likely to be admitted to ICU and had the higher mortality than whites.
Preprint Features of 16,749 hospitalised UK patients with COVID-19 us...
Article Ethnicity and Outcomes from COVID-19: The ISARIC CCP-UK Pros...
High plasma glucose levels and diabetes mellitus (DM) are known risk factors for pneumonia. Potential mechanisms that may increase the susceptibility for COVID-19 in patients with DM include the following:
Higher-affinity cellular binding and efficient virus entry
Decreased viral clearance
Diminished T-cell function
Increased susceptibility to hyperinflammation and cytokine storm syndrome
Presence of cardiovascular disease
Please have a look at the link below:
Article COVID-19 in diabetic patients: Related risks and specifics o...
Article Diabetes and covid-19: A global health challenge
Article COVID-19 and diabetes management: What should be considered?
Also, see the link below.
https://www.nature.com/articles/s41574-020-00435-4
