**6. Effect of COVID-19 on diabetes**

COVID 19 infection in patients multiplexes the glucocorticoids and catecholamines in the circulation. These are two factors causing uncontrolled glucose levels in the blood, damage the majority of vital organs, and worsen the outcome of the disease.

#### **6.1 Effect of corticosteroids**

In case of severe infection, to suppress the inflammatory progress, corticosteroids include hydrocortisone. However, the complications due to administration of these drugs found high comprise as raising 80% of blood glucose levels among diabetic patients and lesser in non-diabetic patients. The mortality rate was higher among diabetic patients with CIVID 19 infection after administration of corticosteroids due to uncontrolled blood glucose levels, necrosis, and psychosis [25, 26]. Glucose monitoring is essential for the patients who all are on the corticosteroids [27].
