In a new paper, researchers say that COVID-19 may actually trigger the onset of diabetes in healthy people and also cause severe complications of pre-existing diabetes.
The statement was signed by an international group of 17 leading diabetes experts involved in the CoviDiab Registry project.
This is a collaborative international research initiative, announces the establishment of a Global Registry of new cases of diabetes in patients with COVID-19.
The Registry aims to understand the extent and the characteristics of the manifestations of diabetes in patients with COVID-19, and the best strategies for the treatment and monitoring of affected patients, during and after the pandemic.
Clinical observations so far show a bi-directional relationship between COVID-19 and diabetes.
On the one hand, diabetes is associated with increased risk of COVID-19 severity and mortality. Between 20 and 30% of patients who died with COVID-19 have been reported to have diabetes.
On the other hand, new-onset diabetes and atypical metabolic complications of pre-existing diabetes, including life-threatening ones, have been observed in people with COVID-19.
It is still unclear how the COVID-19 virus impacts diabetes.
Previous research has shown that ACE-2, the protein that binds to SARS-Cov-2 allowing the virus to enter human cells, is not only located in the lungs but also in organs and tissues involved in glucose metabolisms such as the pancreas, the small intestine, the fat tissue, the liver, and the kidney.
Researchers hypothesize that by entering these tissues, the virus may cause multiple and complex dysfunctions of glucose metabolism. It has also been known for many years that virus infections can precipitate type 1 diabetes.
The team says diabetes is one of the most prevalent chronic diseases and we are now realizing the consequences of the inevitable clash between two pandemics.
Given the short period of human contact with this new coronavirus, the exact mechanism by which the virus influences glucose metabolism is still unclear.
Scientists don’t know whether the acute manifestation of diabetes in these patients represents classic type 1, type 2 or possibly a new form of diabetes.
By establishing this Global Registry, the researchers are calling on the international medical community to rapidly share relevant clinical observations that can help answer these questions.
One author of the study is Francesco Rubino, Professor of Metabolic Surgery at King’s College London.
The study is published in the New England Journal of Medicine.
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