Covid-19 e Diabetes Mellitus: impactos no processo contínuo de cuidado - uma revisão.

Abstract

The pandemic caused by the new coronavirus has alarmingly affected millions of people, leading to death in a considerable part of the population. Among the main factors for worse clinical outcomes of COVID-19 infection, is diabetes mellitus, characterized by increase in glycemic levels due to disturbances in the production and/or action of insulin in cells. Due to the high risk of contagion and the lack of clarity of information, especially at the beginning of the pandemic, social isolation came as a consequence, in order to prevent the spread of the virus, harming social contact and access to

health services. Given these conditions, care for diabetic patients has become if even more important and essential in the course of the pandemic, to avoid aggravations or even

even reduce mortality in this population. It was proposed in this study to analyze the management of the general care of individuals with diabetes mellitus during the pandemic of COVID-19, from the literature. This is an integrative literature review, based on of articles available on digital platforms: PubMed, MEDLINE and SciELO, in Portuguese, English and Spanish languages. The descriptors used to search for articles were: diabetes mellitus, COVID-19 and hypoglycemic drugs, with a focus on GLP-1. the articles, once located, a total of 10 were included after reading the titles, followed by through the abstracts and, at the end, its full reading, going through the inclusion criteria and proposed exclusion. Multiple mechanisms may explain the increased susceptibility of diabetics to respiratory infections, one of them is the overexpression of the cell membrane that serves as a receptor for the virus and an inflammatory response exacerbated, increasing the risk of decompensation and the onset of seizures hyperglycemic. Other mechanisms are given by the increase in binding affinity between the protein and the virus and the reduction of the function of the defense cells. So, the Glycemic control is crucial for disease control and consequent risk reduction of criticality in cases of SARS-CoV-2 infection.treatment routines and care of diabetic patients, was greatly affected during the peak of the pandemic, with treatment interruptions at health centers, limited access to medicines and other applied technologies. Care strategies have been tried and

adopted during this period, as is the case of the GLP1-RAs and their possible anti- inflammatory conditions, in addition to alternative care therapies, such as teleservices. THE

From the data obtained, greater susceptibility was seen in diabetics to higher complications of COVID-19, the positive action of some oral antidiabetic drugs and also the insulin, depending on the severity of the infection, in addition to positive impacts of care with guidelines on glycemic control, specialized care and other support measures, such as psychological support, aimed at the treatment of of DM, reinforcing that more research and prospective studies are carried out to the discovery and proof of more care therapies against COVID-19.