New study finds higher rates of newly diagnosed typediabetes after
infection with mild COVID-19
Date:
March 17, 2022
Source:
Diabetologia
Summary:
New research suggests a possible association between mild COVID-19
cases and subsequently diagnosing type 2 diabetes.
FULL STORY ==========================================================================
New research published in Diabetologia(the journal of the European
Association for the Study of Diabetes [EASD]), suggests a possible
association between mild COVID-19 cases and subsequently diagnosing type
2 diabetes.
==========================================================================
The analysis of health records from 1,171 general and internal medicine practices across Germany conducted by Professor Wolfgang Rathmann and
Professor Oliver Kussfrom 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 have a significantly higher risk of developing type 2 diabetes than a matched control group who had other types of respiratory infections, which are also frequently caused by viruses.
If confirmed, these results indicate that diabetes screening in
individuals after recovery from mild forms of COVID-19 should be
recommended, researchers say. This potential link between COVID-19
and diabetes is also being investigated in various ongoing studies,
including on the CoviDiab registry and other studies connected to so
called 'long COVID'.
Previous studies have noted that inflammation caused by SARS-CoV?2 may
damage insulin-producing beta cells, causing them to die or change how
they work, resulting in acute hyperglycaemia (high blood glucose). Tissues becoming less reactive to insulin due to inflammation in the body is
also thought to be a possible cause. Sedentary lifestyles brought on by lockdowns could also be playing a role. This may explain why new-onset hyperglycaemia and insulin resistance have been reported in COVID-19
patients with no prior history of diabetes.
However, it is unclear whether these metabolic changes are temporary or
whether individuals with COVID-19 may be at increased risk of developing chronic diabetes. Furthermore, there is a lack of studies investigating
the incidence of diabetes after recovery from COVID-19 in mild cases.
To provide more evidence, the researchers analysed electronic health
records from the Disease Analyzer database, which included information
on 8.8 million adults who visited 1,171 general and internal medicine
practices across Germany between March 2020 and January 2021. This
included 35,865 patients who were diagnosed with COVID-19. The incidence
of diabetes after COVID-19 was compared with a cohort of individuals
(average age 43 years; 46% women) who were diagnosed with an acute
upper respiratory tract infection (AURI) (but not COVID-19) within
the same timeframe, matched for 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.
Individuals with a history of COVID-19 or diabetes, and those using corticosteroids within 30 days after the index dates were excluded. During
an average follow-up of 119 days for COVID-19 and 161 days for AURI, the numbers of hospitalisations were similar in both groups (COVID-19: 3.2%
vs controls: 3.1%; median number of hospital stays: 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 those with an AURI
(15.8 vs 12.3 per 1000 people per year) giving an incidence rate ratio
(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 was not increased 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 for developing diabetes due to having obesity or prediabetes, and the stress COVID-19
put on their bodies speeded it up," says lead author Professor Wolfgang Rathmann. "The risk of abnormally high blood sugar in individuals with
COVID-19 is most likely a continuum, depending on risk factors such as
injury to beta cells, an exaggerated inflammatory response, and changes
in pandemic-related weight gain and decreased physical activity," adds co-author Professor Oliver Kuss.
Prof Rathmann adds: "Since the COVID-19 patients were only followed for
about three months, further follow-up is needed to understand whether type
2 diabetes after mild COVID-19 is just temporary and can be reversed after
they have fully recovered, or whether it leads to a chronic condition." Although type 2 diabetes is not likely to be 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 right away.
The authors note some limitations to their study, including that
limited information on hospitalisations and individuals diagnosed with
COVID-19 outside of general practice (e.g. in hospitals or at COVID-19
test centres) may limit the accuracy of the results. Similarly, they
were unable to control for body mass index because the data were not
available and the incidence of type 1 diabetes was not investigated due
to the small number of cases. Finally, they note that their findings
might not be generalisable to other populations.
========================================================================== Story Source: Materials provided by Diabetologia. Note: Content may be
edited for style and length.
========================================================================== Journal Reference:
1. Wolfgang Rathmann, Oliver Kuss, Karel Kostev. Incidence of newly
diagnosed diabetes after Covid-19. Diabetologia, 2022; DOI:
10.1007/ s00125-022-05670-0 ==========================================================================
Link to news story:
https://www.sciencedaily.com/releases/2022/03/220317094740.htm
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