The New England Journal of Medicine published a paper signed by 17 leading diabetes experts, highlighting the new cases of diabetes in COVID-19 patients. The purpose of the letter is to understand the extent and the characteristic manifestations of diabetes in COVID positive patients.
So far clinical findings have shown that there is a bi-directional relationship between diabetes and COVID-19 (SARS-Cov-2). What’s more, diabetes is associated with an increased risk of severity and mortality of COVID-19. 20 to 30% of the patients who have died because of COVID-19 have been reported to have diabetes. Similarly, atypical metabolic complications of preexisting diabetes and new-onset diabetes has also been observed in patients with COVID-19.
However, it is still not clear how SARS-Cov-2 impacts diabetes. According to previous research, ACE-2, the protein that binds to SARS-Cov-2 that allows the virus to enter human cells in not only located in the lungs, but, also in organs and tissues that are involved in the metabolism of glucose, for example, kidney, liver, fat tissue, small intestine and pancreas. It has been concluded by researchers that the virus may cause multiple and complex dysfunctions of glucose metabolism by entering these tissues. Furthermore, viral infections can also precipitate type 1 diabetes.
“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,” said Francesco Rubino, Professor of Metabolic Surgery at the School of Life Course Sciences and co-lead investigator of the CoviDiab project
According to Paul Zimmet, Professor of Diabetes at Monash University in Melbourne, Honorary President of the International Diabetes Federation and co-lead investigator in the CoviDiab 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. 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”.
Furthermore,
“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. Studying COVID-19-related diabetes may uncover novel mechanisms of disease,” said Stephanie Amiel, Professor of Diabetes Research at King’s College London and a co-investigator of the CoviDiab project.
Reference:
New England Journal of Medicine (2020). DOI: 10.1056/NEJMc2018688
