While the cause is unclear, emerging research suggests a link between COVID-19 and the onset of new diabetes, along with severe complications of pre-existing diabetes.
An international group of 17 leading diabetes experts involved in the ‘CoviDiab Project’ signed a letter published recently in the New England Journal of Medicine, which says that clinical observations have shown a bi-directional relationship between COVID-19 and diabetes.
Diabetes is known to increase the risk of COVID-19 severity and mortality – between 20-30% of patients who died with COVID-19 have been reported to have diabetes.
Clinical observations have also shown the development of new-onset diabetes and atypical metabolic complications of pre-existing diabetes in people with COVID-19.
Researchers hypothesis that by entering organs and tissues involved in glucose metabolism (the pancreas, the small intestine, the fat tissue, the liver and the kidneys), COVID-19 may cause multiple and complex dysfunctions of glucose metabolism.
“Diabetes is one of the most prevalent chronic diseases and we are now realising the consequences of the inevitable clash between two pandemics,” says Professor of Metabolic Surgery at Kind’s College London, Francesco Rubino.
“”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.”
Paul Zimmet, Professor of Diabetes at Monash University in Melbourne, Honorary President of the International Diabetes Federation and co-lead investigator in the ‘COVID-19 Project’ adds: “We don’t know the magnitude of the new onset diabetes in COVID-19 and if it will persist or resolve after the infection; and if so, whether or not COVID-19 increases risk of future diabetes.”
The letter published in the New England Journal of Medicine also announced the establishment of a Global Registry of new cases of diabetes in patients with COVID-19.
“The registry focuses on routinely collected clinical data that will help us examine insulin secretory capacity, insulin resistance and autoimmune antibody status to understand how COVID-19-related diabetes develops, it’s natural history and best management,” says Professor of Diabetes Research at Kind’s College London and co-investigator of the ‘CoviDiab Project’, Stephanie Amiel.
“Studying COVID-19 related diabetes may uncover novel mechanisms of disease.”
To read the letter, visit: nejm.org/doi/full/10.1056/NEJMc2018688?query=featured_home