COVID-19 May Trigger the Onset of Diabetes in Some People- Know What Researchers Have to Say

The scientists say that a possibility of the novel coronavirus may alter glucose metabolism that could complicate the condition of pre-existing diabetes or lead to new mechanisms of disease.

The virus may trigger the onset of diabetes in non-diabetic healthy people, and also cause severe complications in diabetic patients, according to an international group of 17 leading experts. To get a better understanding of exactly how COVID-19 and diabetes interact, experts just announced they’ll be collecting data through a new global registry called the CoviDiab Registry.

As per the clinical observations made so far, the scientists, including Stephanie A. Amiel from King’s College London in the U.K., explained there is a bi-directional relationship between COVID-19 and diabetes. Earlier in the coronavirus pandemic, doctors learned that people with diabetes face a greater risk of developing serious complications from COVID-19 infections. What they didn’t immediately figure out was that the new coronavirus might trigger diabetes in people who didn’t have the blood sugar disease before.

Dr. Francesco Rubino, a professor of metabolic and bariatric surgery at King’s College London in the United Kingdom shared in a letter that the evidence so far is clear that there is a link between diabetes and COVID-19. The association is bi-directional because diabetes is associated with severe COVID-19 manifestations and, conversely, COVID-19 is associated with severe manifestations of pre-existing diabetes.

“Because of the preliminary nature of these observations, we have launched the international registry to quickly gather more evidence and confirm or dispel the concerns that the virus may indeed induce diabetes,” he further explained.

Rubino admitted that it’s not yet clear how COVID-19 might trigger diabetes. He said there are known stress responses that can make pre-existing diabetes worse or unmask already existing diabetes. Some of the treatments used for viruses are known to increase blood sugar levels, so that could be responsible, too.

Previous research also showed that the coronavirus responsible for SARS (severe acute respiratory syndrome) seemed to trigger an acute type of diabetes. Chances seem that virus also directly affects the pancreas (the major organ involved in diabetes). 

Sanjoy Dutta, vice president of research for JDRF (formerly the Juvenile Diabetes Research Foundation), agreed that there are a number of potential ways that coronavirus might lead to diabetes.

“The idea of a viral trigger has been associated with type 1 diabetes but is definitely not proven. There are so many viruses and so many viral infections and, fortunately, the number of people with type 1 diabetes is much, much lower,” he mentioned. 

Dutta explained that there are other pathways in the body that can create an imbalance of blood sugar that could trigger acute diabetes. He added that this type of diabetes might go away if blood sugar levels are kept in control, but it’s still unknown.

While the registry is collecting data and getting a better understanding of how the two conditions affect each other, there are some precautions people can take:

• In case you already have diabetes:

“Having diabetes clearly increases the risk of experiencing more severe COVID-19 [infections], as well as complications from diabetes itself,” Rubino stated. Keeping yourself away from infection is even more important for people with diabetes. Diabetics need to be extra cautious and follow public health advice — such as hand-washing, social distancing and wearing a mask — to reduce the risk of catching an infection.

People with diabetes should monitor their blood sugar levels. If blood sugar levels are higher than they should be, consult your doctor. Also, regularly checking your blood sugar can help you avoid serious diabetes complications if you develop a COVID-19 infection and don’t realize it.

• In case, you fall in pre-diabetic stage or are at high risk of diabetes:

If you are pre-diabetic or you’re at high risk of developing diabetes due to conditions such as obesity, taking steps to maintain a healthy lifestyle may be more important than ever to help prevent diabetes. Following public health guidelines strictly to try to avoid infection is important for people with pre-diabetes and a high risk of diabetes, too.

• If you have COVID-19, but don’t have diabetes:

If you’ve been diagnosed with COVID-19, but don’t have diabetes, be wary of the sudden onset of similar symptoms that could indicate diabetes. These include being very thirsty, needing to urinate more than usual, feeling fatigued, having blurry vision or feeling confused. These symptoms could signal complications of diabetes that require urgent medical attention, Rubino warned.

Dutta said if you know you have a family history of diabetes, especially type 1 diabetes, it’s better to let your doctor know in advance because you have a higher risk of developing diabetes.

The potentially lasting risk might be possible

For those who develop diabetes during a COVID-19 infection and then get better, Rubino said doctors don’t yet know if the risk of diabetes will return to normal, or if it will remain higher for an extended period.

“Until we know more, it is prudent to assume that patients who have had diabetes during the course of COVID-19 could be at increased risk of diabetes later on even if diabetes resolves after the infection,” he suggested.

Over to you

Rubino advises doctors to monitor anyone who got diabetes during a COVID-19 infection over time to see what happens to their blood sugar levels. He added that the global registry is accessible by any physician around the world, and he encourages doctors to share their findings to increase understanding of the COVID-19/diabetes association. This new registry information was recently published online as a letter in the New England Journal of Medicine.