Mild COVID-19 may increase diabetes risk

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A new study examines the link between COVID-19 and type 2 diabetes. Sergei Filimonov/Stocksy
  • A recent study followed people with mild COVID-19 to determine if they had an increased risk of developing type 2 diabetes.
  • As a control, they also followed people with an acute upper respiratory infection (AURI).
  • The researchers concluded that people with mild COVID-19 had a higher risk of developing type 2 diabetes than those with AURI.
  • The authors say more research is needed to determine whether this is a short- or long-term health problem.

Following infection with SARS-CoV-2, some people develop long COVID. These people may experience fatigue, brain fog, and general pain that can last for months.

A group of researchers recently studied whether COVID-19 could also increase the risk of developing type 2 diabetes. They published their findings in the journal Diabetology.

According to the Centers for Disease Control and Prevention (CDC), type 2 diabetes, the most common form of diabetes, affects approximately 1 in 10 people in the USA.

With so many people infected with SARS-CoV-2, even a relatively small increase in diabetes risk after COVID-19 could put considerable strain on an already overstretched healthcare system.

According to the authors, the SARS-CoV-2 virus targets the pancreas – the site of insulin production. They also note that “new-onset hyperglycemia and insulin resistance have been reported in patients with” COVID-19.

With this in mind, they set out to study the prevalence of type 2 diabetes following mild cases of COVID-19.

The authors consulted the patient records of 8.8 million people in Germany. Using these records, they focused on people with a diagnosis of COVID-19 or AURI in a primary care setting.

Initial patient visits were made from March 2020 to January 2021. The researchers then looked for people with COVID-19 or AURI who also made follow-up appointments.

In total, the study compared 35,865 COVID-19 patient records with 35,865 AURI patient records.

The authors found that a higher percentage of people with COVID-19 developed type 2 diabetes within months of infection.

Of those with COVID-19, 15.8 per 1,000 developed type 2 diabetes. Among those with AURI, 12.3 per 1,000 developed type 2 diabetes.

This means that the relative risk of developing diabetes was 28% higher in people with COVID-19.

“COVID-19 infection may lead to diabetes through upregulation of the immune system after remission, which may induce pancreatic beta cell dysfunction and insulin resistance, or patients may have been at risk for developing diabetes due to obesity or prediabetes, and the COVID-19 stress put on their bodies accelerated it,”

– Teacher. Wolfgang Rathmann, lead author

Professor Rathmann is affiliated with the German Diabetes Center at Heinrich Heine University in Düsseldorf, Germany.

Medical News Today discussed these results with Dr. Swapnil Khare who was not involved in the study. Dr. Khare is an assistant professor of clinical medicine in the Division of Endocrinology, Diabetes, and Metabolism at Indiana University School of Medicine in Indianapolis.

Explaining why there might be a link between COVID-19 and diabetes, she said: “Previous studies have shown that there is a link with viral infection and the development of diabetes. They suggest that the viral infection serves as a second trigger in people already predisposed to developing diabetes.

“We know that COVID-19 causes an increase in inflammatory markers, which can cause pancreatic dysfunction,” she explained. “In addition, certain drugs used to treat [SARS-CoV-2] infection can increase the risk of diabetes.

This study could help shape how people are treated after COVID-19 symptoms resolve.

Dr Khare said DTM that we need to understand if “we need standard screening for patients with [SARS-CoV-2] infections and when we should test.

Additionally, the study can give health care providers an idea of ​​what to expect in the future regarding patient load.

“Given the large number of people with COVID-19, these absolute numbers could translate into a substantial population-level burden and could further strain already overstretched health systems,” said Dr Ziyad Al. -Aly on Twitter.

Dr. Al-Aly is Director of the Center for Clinical Epidemiology and Chief of Research and Education at the Veterans Affairs Health Care System in St. Louis, MO.

The authors note that the study has some limitations. For example, they could not take participants’ body mass index (BMI) into account in their analysis.

Since overweight and obesity are risk factors for diabetes, this may have influenced the results.

Additionally, as Professor Rathmann explains, the researchers did not follow the participants for a long time:

“Further follow-up is needed to understand if type 2 diabetes after mild COVID-19 is just temporary and can be reversed after they fully recover, or if it leads to chronic disease.”

“We need more studies to see if type 2 diabetes after COVID-19 is reversible,” Dr. Khare agreed before highlighting some of the many outstanding questions:

“People who have other predisposing factors […] more likely to develop diabetes after COVID-19 or are we looking at new factors? Is there a difference between races and ethnicity? [The] the average age is in the early 40s in this study, so we need additional data to look at younger and older people.

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