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COVID-19 triggers the onset of diabetes in some patients

A new study from Kings College London reports that COVID-19 can actually trigger the onset of diabetes in healthy patients and cause unusual complications in patients with pre-existing diabetes.

A team of experts involved in an international research initiative, the CoviDiab Registry project, has now established a Global Registry to document all new cases of COVID-19 patients with diabetes.

The goal of the Registry is to analyze the manifestations of diabetes in patients with COVID-19, and to identify the best strategies for treatment and monitoring, even after the pandemic.

Stephanie Amiel is a professor of Diabetes Research at King’s and a co-investigator of the CoviDiab Registry project. 

“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, its natural history and best management,” said Professor Amiel. “Studying COVID-19-related diabetes may uncover novel mechanisms of disease.”

As many as 30 percent of patients who have died from COVID-19 had diabetes. The latest research has produced evidence of a bi-directional relationship between the two conditions. While diabetes increases the risk of developing a severe and life-threatening infection, COVID-19 is linked to new-onset cases and unusual metabolic complications of pre-existing diabetes.

Francesco Rubino is a professor of Metabolic Surgery at King’s and co-lead investigator of the CoviDiab Registry project.

“Diabetes is one of the most prevalent chronic diseases and we are now realizing the consequences of the inevitable clash between two pandemics,” said Professor 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.”

The findings of previous studies suggest that ACE-2, the protein that is exploited by SARS-Cov-2 to gain initial entry into human cells, may also provide a gateway for the virus to disrupt the production or activity of insulin.

The ACE2 protein is not only present in the lungs, but also in organs and tissues that are involved in glucose metabolism such as the pancreas, small intestine, fat tissue, liver, and kidneys. Experts theorize that by entering these tissues, the virus may cause multiple and complex dysfunctions of glucose metabolism. 

Paul Zimmet is a professor of Diabetes at Monash University and co-lead investigator in the CoviDiab Registry project. 

“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,” said Professor Zimmet. “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”.

The study is published in the New England Journal of Medicine.

By Chrissy Sexton, Staff Writer


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