As COVID-19 spread around the world, what was originally thought to be a highly infectious respiratory illness became much more. Doctors began to see that in addition to the lungs, coronavirus could damage the heart and kidneys, and cause blood-clotting, neurological problems and other long-term issues. Now, some physicians think COVID-19 could trigger diabetes in patients with no history of the disease.
Experts at Baptist Health say there’s no need to panic that you’ll develop diabetes if you’ve had COVID-19. But they suggest that your blood sugar be monitored during and after recovery in follow-up visits with your physicians.
“It’s common during any serious illness or trauma for the body to react by raising blood sugar, causing hyperglycemia,” said endocrinologist Herberto Valdes, M.D., with Baptist Health Medical Group. “But severe COVID has been associated with diabetes mellitus and worsening glucose control. The virus attaches to ACE2 receptors, which are present in pancreatic cells.”
Researchers are trying to determine if these patients developed hyperglycemia due to a stress response associated with severe illness, or if the damage in the pancreas led to insulin deficiency.
Type 1 diabetes occurs when the body suddenly stops producing insulin, a hormone that regulates glucose, or sugar, in the blood. Type 2 diabetes usually comes on over time and can be the result of an inactive lifestyle and poor eating habits. No matter the type of diabetes a person has, it can lead to long-term health problems such as heart and kidney disease, vision loss and other complications.
Reports of the link between COVID-19 and diabetes first came from physicians outside of the United States, who noticed that a small number of hospitalized patients with no known history of diabetes seemed to suddenly develop the disease.
Those affected appeared to have type 1 diabetes at first and were given insulin injections. Over time, however, some patients experienced improvement and were able to control their blood sugar with the oral medications most commonly used to treat type 2 diabetes. A combination of the two types is puzzling, the physicians say.
In a letter published in The New England Journal of Medicine, the doctors wrote: “These manifestations of diabetes pose challenges in clinical management and suggest a complex pathophysiology of COVID-19-related diabetes.” As a result of their observations, the doctors created a registry that will allow physicians around the world to upload information about COVID-19 patients with abnormal blood sugar levels. They hope this will help them understand how common the phenomenon is, as well as lead to solutions.
“We know that diabetes is often a silent disease. Many people don’t even know they have it,” said family medicine physician Maria Ordonez, M.D., with Baptist Health Primary Care. “There’s no need to be overly anxious about this, but whether you have had COVID-19 or not, you should have your blood sugar checked at your annual check-up with your primary care physician.” If you have risk factors, already know you are pre-diabetic or have been diagnosed with diabetes, you will undergo much more frequent testing.
The doctors also recommend testing if you have any symptoms of diabetes, such as frequent urination, weight loss for no apparent reason, excessive thirst, blurry vision or other problems. For a more complete list of symptoms, check the U.S. Centers for Disease Control and Prevention here. And for risk factors, click here.
From the start of the pandemic, there have been warnings that people with underlying health conditions are more susceptible to COVID-19. If you have diabetes, it does not mean you are more likely to get COVID-19, Dr. Valdes explained. “However, it does mean that if you do get COVID-19, you are at a higher risk of having a more severe case or more complications,” he said.
Drs. Valdes and Ordonez agree that further research into COVID-19-related diabetes is warranted as it may help doctors better identify patients who may be predisposed to the condition, as well as develop possible treatments. “With or without COVID-19, diabetes can be very debilitating,” Dr. Ordonez said. “The earlier it is caught, the better.”
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