COVID-19 continues to throw us new curves, and one of them is growing evidence of a troubling link that is beginning to emerge between COVID-19 infection and the development of diabetes.
Dr. Carolina Solis-Herrera, endocrinologist with University Health’s Texas Diabetes Institute and division chief of endocrinology at UT Health San Antonio, describes what we are learning about COVID-19 and diabetes, in English and Spanish.
Does it appear that COVID-19 can worsen diabetes, or even cause it?
Multiple studies have shown that there is an increase in the incidence of new onset diabetes in patients in the hospital that have COVID-19. It seems to be about 14%. There could be multiple factors associated with this.
One of the theories is the increase in the attachment to those receptors called ACE2 receptors, which are found in multiple organs including the lungs, intestines, the pancreas and the heart. This could be associated not only with the appearance of diabetes, but also with some other complications we see like pneumonia and myocarditis associated with COVID-19.
Have we seen physical evidence of direct damage to the pancreas in patients with COVID-19?
There are newly released studies that have shown in autopsies of patients with COVID-19, looking specifically at the pancreas and looking at the beta cell that produces insulin, that there is a direct damage of the cells in patients with COVID-19. We believe this might be a direct association with that insulin deficiency in the development of diabetes in these patients.
Do we know yet who is most vulnerable to developing diabetes after they have contracted COVID-19?
We know that there are people at risk of developing diabetes in general. For example, patients with family history of diabetes, patients with obesity, those who are sedentary, those patients are more prone to develop diabetes.
It is possible that this particular subset of patients, also patients with pre-diabetes which is abnormal glucose but not in a diabetes range, are more prone to develop diabetes if they acquire COVID-19.
Has the COVID-19 pandemic worsened the diabetes epidemic in ways like delaying medical care?
Unfortunately, we have seen this phenomenon in the last couple of years, especially in the first year and before we had the vaccinations, we saw that patients would delay their medical care.
We saw a spike in complications in diabetes and other chronic diseases like heart failure. Patients would come to the hospital a lot sicker.
Fortunately, now with vaccinations and telemedicine, people now are procuring medical care so much more than last year.