COVID-19 may elevate the risk of hyperglycemia and other complications in patients with and without prior diabetes history.

Individuals with preexisting diabetes show higher incidence of COVID-19 illness and poorer prognosis upon infection. Likewise, an increased frequency of diabetes onset and diabetes complications has been reported in patients following COVID-19 diagnosis.

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• Evidence suggests that people with diabetes and COVID-19 are at higher risk of severe complications, such as ketosis, ARDS, kidney disease, ischemic heart disease, maladaptive immune response, and mortality.
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• Numerous studies have also raised concerns of new-onset diabetes developed in the COVID-19 setting that could be mediated by the interaction of SARS-CoV-2 with the renin-angiotensin-aldosterone system.
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• The use of technologies to monitor glucose levels following a COVID-19 diagnosis may assist with hyperglycemia management among patients with existing and new-onset diabetes. 
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• High priority should be placed on further understanding the metabolic and physiologic parameters of diabetes and COVID-19, with consideration for wearable technology as a useful tool for effective management. 
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• Technologies can assist with diabetes monitoring and management. Several technologies are available for the management of diabetes conditions and related complications such as continuous glucose monitoring (CGM), glucometers, HbA_1c at-home testing, smartphone applications for food, fitness, and sleep, and stretchable electronics.

Despite intensive global vaccination efforts to combat the COVID-19 pandemic, circulating SARS-CoV-2 genetic variants and sustained case and transmission rates underline the need for increased attention to diabetes and diabetes complications after COVID-19 diagnosis and recovery.

This review summarizes current data about the epidemiology and mechanisms of the bidirectional relationship between COVID-19 and diabetes with a focus on new-onset diabetes.

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