New study finds higher rates of newly diagnosed type 2 diabetes after mild COVID-19 infection Covid-19 confers increased risk of type 2 diabetes. If confirmed, these results support active control of glucose dysregulation after recovery from mild forms of respiratory syndrome coronavirus 2 (SARS-CoV-2) infection severe acute. |
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New research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]), suggests a possible association between mild cases of COVID-19 and the subsequent diagnosis of type 2 diabetes.
Analysis of health records from 1,171 general and internal medicine practices across Germany by Professor Wolfgang Rathmann and Professor Oliver Kuss of the German Diabetes Center at Heinrich Heine University, Dusseldorf, Germany, and Professor Karel Kostev (IQVIA *, Frankfurt, Germany) found that adults who recover from mostly mild COVID-19 appear to be at significantly higher risk of developing type 2 diabetes than a matched control group who had other types of respiratory infections, which are also caused often by viruses.
If confirmed, these results indicate that diabetes screening should be recommended in individuals after recovery from mild forms of COVID-19, the researchers say.
This possible link between COVID-19 and diabetes is also being investigated in several ongoing studies, including in the CoviDiab registry and other studies related to so-called "long COVID."
Previous studies have noted that inflammation caused by SARS-CoV-2 can damage insulin-producing beta cells, causing them to die or changing their function, leading to acute hyperglycemia (high blood glucose). A possible cause is also thought to be tissues becoming less reactive to insulin due to inflammation in the body.
Sedentary lifestyles brought on by lockdowns could also be playing a role. This may explain why cases of new-onset hyperglycemia and insulin resistance have been reported in COVID-19 patients without a history of diabetes.
However, it is unclear whether these metabolic changes are temporary or whether people with COVID-19 may be at increased risk of developing chronic diabetes. Furthermore, studies investigating the incidence of diabetes after recovery from COVID-19 in mild cases are lacking.
To provide further evidence, researchers analyzed electronic health records from the Disease Analyzer database, which included information on 8.8 million adults who visited 1,171 general and internal medicine offices in Germany between March 2020 and January of 2021.
This included 35,865 patients who were diagnosed with COVID -19. The incidence of diabetes after COVID-19 was compared to a cohort of people (average age 43 years; 46% women) who were diagnosed with acute upper respiratory tract infection (AARI) (but not COVID-19) in the same time period matched by sex, age, health insurance coverage, index month of COVID-19 or AURI diagnoses, and comorbidities (obesity, high blood pressure, high cholesterol, heart attack, stroke). Regression models were used to calculate incidence rate ratios (IRRs) for type 2 diabetes and other forms of diabetes.
People with a history of COVID-19 or diabetes, and those who used corticosteroids within 30 days of the index dates were excluded. During a median follow-up of 119 days for COVID-19 and 161 days for AURI, the number of hospitalizations was similar in both groups (COVID-19: 3.2% vs controls: 3.1%; median hospitalizations: 1 in both cohorts).
The researchers found that new cases of type 2 diabetes were more common in patients who tested positive for COVID-19 than in those with an AURI (15.8 vs. 12.3 per 1,000 person-years), which gives an incidence rate (IRR) of 1.28. In simple terms, this means that the relative risk of developing type 2 diabetes in the COVID group was 28% higher than in the AURI group. The IRR for the COVID group did not increase in other unspecified forms of diabetes.
"COVID-19 infection may lead to diabetes by upregulation of the immune system after remission, which may induce pancreatic beta cell dysfunction and insulin resistance , or patients may have been at risk of developing diabetes due to obesity or prediabetes, and the stress COVID-19 put on their bodies accelerated it," says lead author Professor Wolfgang Rathmann.
“The risk of abnormally high blood sugar levels in people with COVID-19 is likely continuous, depending on risk factors such as beta cell injury, an exaggerated inflammatory response, and changes in weight gain related to the pandemic and decreased physical activity,” adds co-author Professor Oliver Kuss.
Professor Rathmann adds: “Since COVID-19 patients were only followed for about three months, more follow-up is needed to understand whether type 2 diabetes after mild COVID-19 is only temporary and can be reversed after it is resolved.” have fully recovered, or if it leads to a chronic condition.
Although type 2 diabetes is likely not a problem for the vast majority of people who have mild COVID-19, the authors recommend that anyone who has recovered from COVID-19 be aware of the warning signs and symptoms , such as fatigue, frequent urination, and increased thirst, and seek treatment immediately.
The authors point out some limitations of their study, including limited information on hospitalizations and individuals diagnosed with COVID-19 outside of general practice (for example, in hospitals or at COVID-19 testing centers) that may limit the accuracy of the results. results. Similarly, they could not control for body mass index because data were not available and the incidence of type 1 diabetes was not investigated due to the small number of cases. Finally, they point out that their findings may not be generalizable to other populations.
