- Diabetes is a significant risk factor for COVID-19, but doctors warn that coronavirus survivors can also develop diabetes after curing a widespread infection.
- Some researchers believe that 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 may be a combination of the two.
- It is not clear whether diabetes after COVID-19 is transient or permanent, but a study has shown that the virus can infect pancreatic cells involved in insulin production.
Diabetes is a major risk factor for patients with COVID-19, but since the early days of the pandemic, doctors have noted that some of the people who survive the infection end up developing diabetes as well. This is a medical condition 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 initial attack with the disease. Since then, additional studies have been published, as doctors are beginning to understand what causes diabetes to appear in COVID-19 survivors. It appears that the virus can infect cells in the pancreas 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 studies underway on diabetes secondary to SARS-CoV-2 infection.
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A report in The Washington Post analyzes recent research on diabetes related to COVID-19, saying it is not yet clear how the disease can trigger type 1 or type 2 diabetes. But the number of diabetes cases following the infection is significant, with one study saying that about 14% of people who survived severe COVID-19 contracted diabetes. The researchers analyzed data from more than 3,700 patients and found that COVID-19 may be the reason these patients developed diabetes.
But new cases of diabetes have also been seen in patients who have had mild or moderate coronavirus.
In type 1 diabetes, people cannot produce their own insulin, necessary to regulate blood sugar. Type 2 diabetes patients produce insulin, but it is insufficient or their bodies reject it. It is not clear what type of diabetes COVID-19 can trigger, as the researchers observed a mixture of diabetes symptoms in patients with COVID-19.
SARS also induced diabetes in survivors, and SARS-CoV-2 appears to behave the same. The report notes that many people who develop diabetes during or after COVID-19 have risk factors for diabetes, including obesity or family history. The use of dexamethasone can also raise blood sugar during COVID-19 therapy. But there are COVID-19 patients with no pre-existing risk factors for diabetes who develop diabetes.
Professor of diabetes surgery at King’s College London Francesco Rubino initiated a global registry of patients with COVID-19 who later developed diabetes, seeking to find similarities between cases that could demonstrate that COVID-19 is indeed a risk factor for diabetes. Rubino said The Post that he believes that COVID diabetes can be different from type 1 and type 2 because 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 and type 2 diabetes, the cells that produce insulin. The next step in proving a link between COVID-19 and diabetes is to study these cells. One way to do this is to look for ACE2 receptors, which the new coronavirus uses to infect cells, in beta cells. The Post notes that the research is inconclusive, as the pancreas decomposes quickly after death, so getting good samples is a challenge.
Cornell University researchers 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 involve patients with COVID-19 and found no evidence of ACE2 receptors in beta cells. A study from Italy found ACE2 receptors on beta cells, but donors had no COVID-19. “Until pancreatic beta cell receptors in the tissue of patients with COVID-19 can be consistently confirmed by other researchers, the search for the mechanism underlying the diabetes-COVID-19 connection continues,” The Post I wrote.
But researchers at Ulm University Hospital may have proved just that. COVID-19 infection can lead to the destruction of beta cells, 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. Scientists have shown that coronavirus can infect the human exocrine (pancreatic juice in digestion) and the endocrine pancreas (hormones like insulin and glucagon) in ex vivo and in vivo experiments. “The 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 demonstrated that the exocrine and endocrine compartments of the pancreas are susceptible to productive SARS-CoV-2 infection, which can disrupt the integrity of β cells,” they concluded. “The mechanism of virus-induced damage and whether the infection has a direct consequence of glucose homeostasis or can even trigger diabetes mellitus remain under discussion and merit further study.”
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 “full recovery” of beta cell function. The full study is available at Nature.
Chris Smith started writing about gadgets as a hobby and, before he knew it, was already sharing his views on technology with readers around the world. Whenever he’s not writing about gadgets, he miserably fails to stay away from them, although he tries desperately. But this is not necessarily a bad thing.