New-Onset Diabetes in Covid-19

There is a bidirectional relationship between Covid-19 and diabetes. On the onehand, diabetes is associated with an increased risk of severe Covid-19. On the other hand, newonset diabetes and severe metabolic complications of preexisting diabetes, including diabetic ketoacidosis and hyperosmolarity for which exceptionally high doses of insulin are warranted, have been observed in patients with Covid-19.1-3These manifestations of diabetes pose challenges in clinical management and suggest a complex pathophysiology of Covid-19–related diabetes.