COVID-19, the disease caused by the new coronavirus, may trigger diabetes in patients, experts in the metabolic condition believe.
In a letter published in the New England Journal of Medicine, an international team of diabetes researchers said COVID-19 has been linked to new cases of the condition. Those who already have diabetes have also been found to experience “severe metabolic complications.” These include problems caused by dangerously high blood sugar levels in type 1 and 2 diabetics.
In the six months since the COVID-19 pandemic started, diabetes has emerged as a risk factor for a severe case of the disease, the authors said. Around 422 million people worldwide have diabetes, according to the World Health Organisation.
Research suggests there is a link between stress and the development of diabetes. The team say that the stress of being seriously ill with COVID-19 could be involved in the new cases. They also say coronavirus may affect how the body processes sugar. The receptor that the virus uses to enter our bodies is found in organs that play a key role in the metabolism, such as the pancreas, fat tissue, small intestine, and kidneys, reports Newsweek.
The team said there are several precedents for viruses causing an intermediate type of diabetes called ketosis-prone diabetes. These include other members of the coronavirus family of pathogens, which enter the body using the same receptor. For instance, patients with severe acute respiratory syndrome (SARS), which is also caused by a coronavirus, are known to develop high blood sugar levels while fasting and acute diabetes. This is also seen in patients with the lung infection pneumonia, which can be caused by viruses.
Paul Zimmet, professor of diabetes at Monash University in Melbourne and Honorary President of the International Diabetes Federation, said in a statement: “We don’t yet 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 or COVID-19 increases risk of future diabetes.”
Zimmet is the co-lead investigator of a new global registry of patients with diabetes linked to COVID-19. It is hoped the CoviDiab Registry project will shed light on the link between the two diseases and find ways to treat these patients.
Francesco Rubino, professor of metabolic surgery at King’s College London and co-lead investigator of the CoviDiab Registry project, said in a statement: “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.”
Zimmet said: “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.”
Anna Morris, assistant director of research at the charity Diabetes U.K. who did not work on the article, toldNewsweek: “We know that there is some evidence to suggest that viruses can—in some cases—trigger type 1 diabetes in those with a predisposition to the condition. That said, although new onset diabetes has been observed in some people with COVID-19, the relationship between the two conditions appears to be complex, and many questions still remain.
Morris said the charity welcomes the launch of the CoviDIAB global registry.
Dr. Katarina Kos, senior lecturer in diabetes and obesity research at the University of Exeter and consultant physician in diabetes who was not involved in the letter, told Newsweek via email it may be that the new type 2 diabetes cases are occurring in patients who already had undiagnosed problems with their metabolism, and high blood sugar levels were a response to the infection.