- Diabetes is a major risk factor for COVID-19, but doctors warn that coronavirus survivors can also develop diabetes after clearing up a covid infection.
- Some researchers think the new coronavirus may determine the onset of a diabetes variation that may not fall into the current Type 1 or Type 2 categories. Instead, it can be a combination of both.
- It’s unclear whether diabetes is temporary or permanent after COVID-19, but one study did show that the virus can infect pancreatic cells involved in insulin production.
Diabetes is one of the main risk factors for COVID-19 patients, but from the start of the pandemic, doctors have noted that some of the people who survived the infection eventually develop 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 first attack with the disease. Additional studies have since been published as doctors begin to understand what causes the onset of diabetes in COVID-19 survivors. It appears that the virus can infect cells of the pancreas and this can lead to diabetes that may never go away. The doctors don’t have all the answers as there are plenty of ongoing studies on diabetes secondary to SARS-CoV-2 infection.
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A report in The Washington Post looks at recent COVID-19-related diabetes research and says it is still unclear how the disease can cause type 1 or type 2 diabetes. But the number of diabetes cases following infection is significant, with one study saying about 14% of people who survived severe COVID-19 developed diabetes. The researchers looked at data from more than 3,700 patients and found that COVID-19 may be why these patients developed diabetes.
But new cases of diabetes have also been seen in patients with a mild or moderate coronavirus.
In type 1 diabetes, people cannot make their own insulin, which is needed to regulate blood sugar. Type 2 diabetics make their insulin, but it is insufficient or their body rejects it. It is unclear what type of diabetes could cause COVID-19, as researchers have seen a mix of diabetes symptoms in COVID-19 patients.
SARS also caused diabetes in survivors, and SARS-CoV-2 appears to have the same behavior. The report notes that many people who develop diabetes during COVID-19 or afterwards have risk factors for diabetes, including obesity or family history. Dexamethasone use can also increase blood sugar during COVID-19 therapy. But there are COVID-19 patients with no existing risk factors for diabetes who develop diabetes.
Francesco Rubino, professor of diabetes surgery at King’s College London, started a global registry of COVID-19 patients who later developed diabetes, looking for similarities between cases that could show that COVID-19 is indeed a risk factor for diabetes. Rubino told The mail that he believes that the COVID diabetes may be different from type 1 and type 2 because it could be a hybrid form. “It’s alarming,” he told the newspaper.
The report explains that pancreatic beta cells play a role in both type 1 and type 2 diabetes, the cells that produce insulin. The next step to prove a link between COVID-19 and diabetes is the study of these cells. One way to do this is to look for ACE2 receptors, which the new coronavirus uses to infect cells, on beta cells. The mail notes that research is inconclusive, as the pancreas breaks down quickly after death, so getting good samples is challenging.
Researchers at Cornell University were able to grow pancreatic cells in a lab and infect them with the coronavirus. Vanderbilt University researchers found ACE2 receptors in the pancreas, but the study did not include COVID-19 patients and found no evidence of ACE2 receptors in beta cells. A study from Italy found ACE2 receptors in beta cells, but the donors did not have COVID-19. “Until receptors in pancreatic beta cells in tissue from COVID-19 patients can be consistently confirmed by other researchers, the hunt for the mechanism underlying the diabetes COVID-19 connection continues,” The mail wrote.
But researchers at Ulm University Hospital may have just proved that. COVID-19 infection can lead to beta cell destruction, 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. The scientists showed that the coronavirus can infect the human exocrine (pancreatic juice in digestion) and endocrine pancreas (hormones such as insulin and glucagon) in both ex vivo and in vivo experiments. Infection is associated with morphological, transcriptional and functional changes, including a reduced number of insulin secretory beads in [beta cells] and decreased glucose-stimulated insulin secretion, ”they wrote.
“We show that the exocrine and endocrine compartments of the pancreas are susceptible to productive SARS-CoV-2 infection, which can disrupt β-cell integrity,” they concluded. “The mechanism of virus-induced damage and whether infection has a direct effect on glucose homeostasis or may even cause diabetes mellitus remain debated and merit future studies.”
Interestingly, the researchers also showed that in ex vivo experiments, remdesivir resulted in an inhibition of viral replication, but this did not lead to a “complete rescue” of beta cell function. The full study is available in Nature.
Chris Smith started writing about gadgets as a hobby and before he knew it, he shared his thoughts on tech matters with readers around the world. When not writing about gadgets, he sadly fails to stay away from them, although he desperately tries. But that’s not necessarily a bad thing.