Dr Cüneyt YARDIMCI
If you have patience to read to the end of the article, you will see that the most up-to-date scientific data – unfortunately – point out an increase in the risk of new onset Type 2 Diabetes development after COVID-19 infection.
At the beginning of the pandemic, it was thought that COVID-19 was a disease that only affects the respiratory tract and was limited to lung damage.
Over time, as the scientific data increased, we learned that SARS CoV-2 is more than a respiratory tract infection, that it is a multi-systemic disease which may affect many systems.
Despite the highest burden of this respiratory transmitted infection is in the airways and lungs, it has the potential to infect and damage all cells in the body, including the heart, brain, kidney, nervous system and reproductive system.
Relationship Between COVID-19 and Type 2 Diabetes: Target is Pancreas
One of the target organs of SARS-CoV-2 is the human pancreas.
Although the pancreas has diverse functions, its basic functions are to regulate blood sugar and aid digestion.
Insulin is secreted by beta cells in this organ.
And the control of blood sugar is mainly managed through this hormone.
Following SARS-CoV-2 infection, a decrease in insulin-secreting granules in beta cells and, accordingly, decreased insulin secretion, which causes deterioration in blood sugar, has been observed in the studies.
As a result of this pathological condition, new-onset hyperglycemia (high blood sugar) and insulin resistance have been reported in patients without a history of diabetes but who had COVID-19.
Although there are many publications on this subject, the most comprehensive study on patients newly diagnosed with Type 2 Diabetes after the COVID-19 infection was published in the March 2022 issue of Diabetologia, which is one of the most reputable scientific publications in the field of diabetes.
In the relevant study, 8.8 million patients’ health records were retrospectively analyzed between March 2020 and January 2021,
And 35,865 patients diagnosed with COVID-19 were selected for the monitoring group, whereas another 35,865 patients diagnosed with any other upper respiratory tract infections (mainly due to reasons such as rhinovirus) were in the comparison group.
The blue line in the chart above represents the rate of new Type 2 Diabetes diagnosis in COVID-19 patients; and the red line is the one for patients diagnosed with any other upper respiratory tract infection.
At the end of the second month, the risk begins to increase in the group that had COVID-19;
After the eighth month, the difference between the curves begins to widen.
However, this increased risk only applies to Type 2 Diabetes;
As seen in the graph below, no increased risk was observed for other types of diabetes.
What Does This Study Show Us About The Relationship With COVID-19 Type 2 Diabetes?
We all know that COVID-19 infection has a wide variety of acute problems ranging from a mild respiratory infection to death,
As well as many undesirable effects and complications of different systems long after the symptoms of active disease disappear.
One of the hypotheses that come to the fore here is that some substances released from our own immune cells during the cytokine storm and the fight against the disease attack may also have a potential threat to damage cells in different parts of our body.
Even after the COVID-19 disease has been overcome, the increase in the cytokines and TNF-α that trigger beta cell dysfunction and insulin resistance in the pancreas continues.
Therefore, there are plausible mechanisms for a causal relationship between COVID-19 and newly diagnosed Type 2 Diabetes;
The detected increase in risk appears to be more than a coincidental possibility.
The strength of the mentioned study listed below increases the power and reliability of the data obtained:
- Using a wide national database instead of collecting records from a specific region
- The fact that patients were recruited from primary care rather than endocrinology or internal medicine, where certain diseases are followed more frequently ( important in terms of reflecting the actual incidence rate in the society )
- Containing a very large number of patient data ( comparing more than thirty-five thousand patients with an equivalent number of control group)
Take Home Message…
Current information indicates that many different system disorders and complications can be experienced under the title of COVID-19, as well as the acute period problems of COVID-19.
In order to understand whether these undesirable long-term effects are permanent or if they are temporary problems that will improve after a while, we need to monitor them for a while and accumulate scientific studies.
In this case, the most correct and rational approach is to continue to strictly comply with the pandemic precautions, especially getting the full dose vaccination.
Because the most pragmatic way to avoid acute and chronic complications of the disease is not to get sick.
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