Emerging Evidence Suggests COVID-19 May Cause Diabetes in Healthy People
Recently collected evidence suggests
that COVID-19 could cause diabetes in healthy individuals and may cause
complications in people who already suffer from diabetes.
A letter published on June 12 in the New England
Journal of Medicine notes that there is a bidirectional relationship between
diabetes and COVID-19. According to the letter, diabetes is linked to an
“increased risk of severe COVID-19,” while doctors have noted “new-onset
diabetes and severe metabolic complications of preexisting diabetes” in
COVID-19 patients.
Diabetes is a disease in which the body’s blood glucose
levels are too high, whether because the pancreas produces little or no
insulin, known as type 1, or because the body has developed a resistance to
insulin, known as type 2.
“These manifestations of diabetes
pose challenges in clinical management and suggest a complex pathophysiology of
COVID-19–related diabetes,” reads the letter, which was signed by an
international group of leading diabetes experts who are part of the CoviDiab
Registry project.
The CoviDiab Registry project is a
research initiative spearheaded by an international group of expert diabetes
researchers. According to data collected in the registry so far, between 20%
and 30% of all people who die from COVID-19 also have diabetes.
Researchers are still uncertain about how SARS-CoV-2, the
virus that causes COVID-19, is related to diabetes. Research so far suggests
that ACE-2, the protein to which the virus binds so that it can enter human
cells, is found in lung tissue cells, but also in the cells of organs involved in
glucose metabolism, including the pancreas, the small intestine, the liver and
the kidneys. Scientists believe that when the virus enters such tissues, it can
cause dysfunction in glucose metabolism.
“Diabetes is one of the most
prevalent chronic diseases, and we are now realizing the consequences of the
inevitable clash between two pandemics. Given the short period of human contact
with this new coronavirus, the exact mechanism by which the virus influences
glucose metabolism is still unclear, and we don't know whether the acute
manifestation of diabetes in these patients represent classic type 1, type 2 or
possibly a new form of diabetes,” Francesco Rubino, co-lead investigator of the
CoviDiab Registry project, said in a statement released by King's College London.
Paul Zimmet, another co-lead
investigator in the CoviDiab Registry project, also explained in the statement
that researchers are still unsure of the “magnitude of the new onset diabetes
in COVID-19.”
“By establishing this Global Registry, we are calling on the
international medical community to rapidly share relevant clinical observations
that can help answer these questions,” he noted.
A study published late May in
the journal Diabetologia found that 1 in 10 patients who have diabetes and also
contract COVID-19 die within seven days of being admitted into the hospital.
The study also found that 1 in 5 patients with both diabetes and COVID-19 end
up being intubated and mechanically ventilated within a week of being
hospitalized. The study was based on 1,317 patients who were admitted to 53
public and private French hospitals between March 10 and March 31. Two-thirds
of the subjects were men.
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