Covid causing diabetes

Diabetes morbidity, India, 77 million, China, 116 million, UK, 3.9million, US 34 million
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UK 3.9 to 4.7 million, + 700 new cases per day

https://www.diabetes.org.uk/about_us/news/new-stats-people-living-with-diabetes

US, 34.2 million

https://www.cdc.gov/diabetes/library/features/diabetes-stat-report.html

Rhino-orbital mucormycosis following COVID-19 in previously non-diabetic, immunocompetent patients

https://www.tandfonline.com/doi/abs/10.1080/01676830.2021.1960382?journalCode=iorb20

India, more than 45,000 cases of Mucormycosis

Affects nose, eyes and sometimes the brain

Usual onset, 12-18 days after recovery from Covid-19

13 of 127 patients had new onset diabetes

Average age, 36 years

Seven of 13, not given steroids or supplemental oxygen

Covid-19: Fears over sharp rise in diabetes in India

https://www.bbc.co.uk/news/world-asia-india-58066767

https://www.sciencedirect.com/journal/diabetes-and-metabolic-syndrome-clinical-research-and-reviews

Dr Anoop Misra

Our assessment is that such patients were probably predisposed to diabetes because of obesity and family history

Severe diabetes caused by pancreatic damage, less common

Proportion of newly diagnosed diabetes in COVID-19 patients: A systematic review and meta-analysis

https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14269

https://www.washingtonpost.com/health/2021/02/01/covid-new-onset-diabetes/

Meta-analysis, 8 studies, n = 3,700 patients

14.4% for newly diagnosed diabetes in hospitalized COVID-19 patients

newly diagnosed diabetes may confer a greater risk for poor prognosis

We are now seeing a classic example of a lethal intersection between a communicable and a non-communicable disease.

Physiology

Stress response associated with severe illness

Treatment with glucocorticoids

Diabetogenic effect of COVID-19 should also be considered

High degree of insulin resistance

High insulin requirements in severely or critically ill COVID-19 patients with diabetes

More diabetic ketoacidosis and hyperosmolar hyperglycaemic in COVID-19 patients with diabetes

SARS-CoV-2), attaching to ACE2 receptors in beta cells

May also injure beta cells by pro-inflammatory cytokines (e.g. interleukin-6)

Enhancing autoimmunity in genetically predisposed people

ACE2 receptors are expressed in the liver, adipose tissue and skeletal muscle

May impair responses to insulin

Exploring research: can coronavirus cause diabetes, or make it worse?

https://www.diabetes.org.uk/about_us/news/new-worse-cases-coronavirus#:~:text=Small%20studies%20looking%20at%20pancreas,can’t%20produce%20enough%20insulin.

https://care.diabetesjournals.org/content/early/2020/08/13/dc20-1551

47,000 people in England, admitted to hospital for coronavirus before August 2020

Seven months after discharged

5% of people went on to develop diabetes

Hospitalised patients, 1.5 times more likely to be diagnosed with diabetes after discharge

Matched with non- hospitalised people of the same age and background

Lets find out

http://covidiab.e-dendrite.com

Post-covid syndrome in individuals admitted to hospital with covid-19: retrospective cohort study

https://pubmed.ncbi.nlm.nih.gov/33789877/

Follow-up of 140 days, 47,780 admissions

14,060 of readmitted (x4)

5,875 died after discharge (x8)

Also increased

Respiratory disease (P 0.001)

Diabetes (P 0.001)

Cardiovascular disease (P 0.001)

Increased rates of multiorgan dysfunction

Source