- Diabetes is a major risk factor for COVID-19, but doctors warn that coronavirus survivors may also develop diabetes after clearing a covid infection.
- Some researchers think the new coronavirus may determine the onset of a variation in diabetes that may not fall into the current type 1 or type 2 categories. Instead, it could be a combination of both.
- It is unclear whether diabetes after COVID-19 is transient or permanent, but one study showed that the virus can infect pancreatic cells involved in insulin production.
Diabetes is a major risk factor for patients with COVID-19, but from the early days of the pandemic, doctors observed that some of the people who survive the infection also end up developing diabetes. It is a disease that affects millions of people worldwide and is currently incurable.
Recent studies have shown that COVID-19 survivors developed diabetes in the weeks and months following their first attack with the disease. Since then, additional studies have been published as doctors begin to understand what causes the onset of diabetes in COVID-19 survivors. It appears that the virus can infect pancreatic cells and this can lead to a case of diabetes that may never go away. Doctors do not have all the answers, as there are many ongoing studies on diabetes secondary to SARS-CoV-2 infection.
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A report a The Washington Post analyzes recent research on COVID-19-related diabetes, saying it is not yet clear how the disease can trigger type 1 or type 2 diabetes. But the number of cases of diabetes following infection is significant, with a study that says that approximately 14% of people who survived severe COVID-19 suffered from diabetes. The researchers examined data from more than 3,700 patients and found that COVID-19 could be the reason these patients developed diabetes.
But new cases of diabetes have also been observed in patients who experienced mild to moderate coronavirus.
In type 1 diabetes, people cannot make their own insulin, which is needed to regulate blood sugar. Patients with type 2 diabetes make their insulin, but it is insufficient or their body rejects it. It is unclear what type of diabetes can cause COVID-19, as researchers have seen a combination of diabetes symptoms in patients with COVID-19.
SARS also induced diabetes in survivors and SARS-CoV-2 appears to have the same behavior. The report notes that many people who develop diabetes during or after COVID-19 have diabetes risk factors, including obesity or a family history. The use of dexamethasone may also raise blood sugar during COVID-19 therapy. But there are COVID-19 patients without pre-existing diabetes risk factors who do develop diabetes.
Diabetes surgery professor at King’s College London, Francesco Rubino, initiated a global registry of patients with COVID-19 who later developed diabetes, seeking to find common ground between cases that could prove that COVID-19 is a risk factor for diabetes. Rubino said The mail who believes that COVID diabetes may be different from type 1 and type 2 diabetes in that it could be a hybrid form. “It’s worrying,” he told the newspaper.
The report explains that pancreatic beta cells are at stake in both type 1 diabetes and type 2 diabetes, the cells that produce insulin. The next step in demonstrating a link between COVID-19 and diabetes is the study of these cells. One way to do this is to look for ACE2 receptors, which the new coronavirus uses to infect cells, into beta cells. The mail points out that the research is inconclusive, as the pancreas decomposes rapidly after death, so obtaining good samples is difficult.
Researchers at Cornell University were able to grow pancreatic cells in a laboratory and infect them with the coronavirus. Researchers at Vanderbilt University found ACE2 receptors in the pancreas, but the study did not include patients with COVID-19 and found no evidence of ACE2 receptors in beta cells. A study in Italy found ACE2 receptors in beta cells, but donors did not have COVID-19. “Until other researchers can consistently confirm pancreatic beta cell receptor tissue in patients with COVID-19, research continues on the mechanism underlying the diabetes-COVID-19 connection.” The mail he wrote.
But researchers at Ulm University Hospital could have proven just that. COVID-19 infection can cause beta cell damage, which can lead to diabetes. The researchers showed that human beta cells express viral entry proteins or ACE2, and the infection can alter the function of beta cells. The scientists showed that coronavirus could infect human exocrine (pancreatic juice in digestion) and endocrine (hormones such as insulin and glucagon) in both ex vivo and in vivo experiments. “Infection is associated with morphological, transcriptional, and functional changes, including a reduced number of insulin-secreting granules in [beta cells] and impaired glucose-stimulated insulin secretion, ”they wrote.
“We demonstrate that exocrine and endocrine compartments of the pancreas are susceptible to productive SARS-CoV-2 infection, which can disrupt β cell integrity,” they concluded. “The mechanism of virus-induced damage and whether the infection has a direct consequence for glucose homeostasis or may even cause diabetes mellitus remain under discussion and deserves future studies.”
Interestingly, the researchers also showed that remdesivir in ex vivo experiments led to an inhibition of viral replication, but this did not lead to a “complete rescue” of beta cell function. The full study is available at Nature.
Chris Smith began writing about gadgets as a hobby, and before he knew it, he was sharing his views on technology issues with readers around the world. Whenever he doesn’t write about gadgets, he can’t get away from them, even though he tries desperately. But this is not necessarily a bad thing.