The prognosis of people with diabetes affected by COVID-19 is particularly bad [1].
There are several possible pathophysiological explanations, including the direct damaging effect of hyperglycemia [2], but, certainly, and hampered immune response, often present in this population, also plays a key role [3], [4].
This reality raises the claim for prioritizing the vaccination against SARS-CoV-2/COVID-19 in people with diabetes [5].
The question, however, might be more complex. The goal of the vaccination is to obtain a sustained and effective immune response. In the case of diabetes the data is controversial, suggesting that not always this result is obtained [6], [7]. Evidence suggests that the glycemic control has a strong impact on the efficiency of the immune response [8], [9]. Therefore, it seems reasonable wondering whether it is not appropriate to improve glycemic control before administering the vaccine to optimize the response to it. Data is needed not to waste this important opportunity to get out of the pandemic for people with diabetes.
Funding
None.
Declaration of Competing Interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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