You’re probably familiar with one well-known link between COVID-19 and diabetes: Diabetes is one of the conditions that put people at a higher risk for complications and death if they contract COVID-19. But scientists are looking into another, more mysterious link between the two, as CBS News reports: COVID-19 infections could trigger new cases of diabetes.
Evidence of this link comes from a systematic review and meta‐analysis published in the journal Diabetes, Obesity, and Metabolism in November 2020. Researchers pooled data from eight studies—conducted in China, Italy, and the U.S. between January and May 2020—that looked at the prevalence of new-onset diabetes in COVID-19 patients. Of the 3,711 COVID-19 patients total, 492 of them (14.4%) developed new cases of diabetes. That doesn’t mean that the coronavirus infections definitely caused their diabetes, but it does suggest that the virus may have played a role.
Only one of the previous studies these researchers included reported whether the patients were diagnosed with type 1 or type 2 diabetes. But evidence suggests a link between COVID-19 and new cases of both types of the disease, The Washington Post reports.
Although the evidence is still preliminary, the possibility that COVID-19 could contribute to type 1 diabetes is “not surprising” to researchers, pediatrician Dyan Hes, M.D., told CBS News on Tuesday. (This is the less common form of the condition in which the body’s immune system attacks its own insulin-making pancreas cells.) In fact, scientists were already investigating the connection between viral infections in general and the onset of type 1 diabetes before the COVID-19 pandemic, so they’ve been looking at the possible link with coronavirus for a while now.
We don’t fully understand the complex autoimmune process that leads to type 1 diabetes. But genetics and environmental triggers, including viruses, can play a role, according to the Centers for Disease Control and Prevention. Experts are now investigating whether or not SARS-CoV-2, the virus that causes COVID-19, can trigger new diabetes cases in this way.
How exactly the virus might lead to new diabetes cases isn’t clear yet, but experts have a few theories. One is that SARS-CoV-2 destroys or alters insulin-producing beta cells in the pancreas possibly by binding to ACE2 receptors, according to a short letter published in the New England Journal of Medicine. These receptors are present in the pancreas, intestines, and kidneys. And a growing body of evidence suggests the virus uses them to infect the body, possibly altering the way the cells that contain ACE2 receptors function the process.
That could potentially explain new cases of type 2 diabetes too. Like type 1, this form of the disease is caused by various factors, including genes and lifestyle, according to the National Institute of Diabetes and Digestive and Kidney Diseases. The process usually starts with insulin resistance (in which the body can’t efficiently use insulin). As a result the pancreas makes more and more insulin, eventually burning out those insulin-making beta cells.
“If scientists could figure out how or if viral infection can damage beta cells, or what role viruses play in the development of the disease, it would be a real turning point,” Katie Colbert Coate, Ph.D., a diabetes researcher and instructor at Vanderbilt University Medical Center, told The Washington Post.
For now scientists are gathering more evidence and looking more closely at these cases to get a better understanding of what’s going on, Dr. Hes explained. Some of the people in the new study may have gone on to develop diabetes anyway, even without COVID-19. Others may have had a family history of diabetes or autoimmune disease, which could have been a factor as well.
Because COVID-19 is a global illness and the link to new diabetes cases has been observed in multiple countries, researchers around the world are pooling data about those patients with a worldwide registry called CoviDIAB. The scientists working on it hope to learn more about how COVID-19-related diabetes develops, as well as the best ways to manage these patients.
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