New cases of diabetes after suffering COVID-19
A Italian Study he found than about half of the patients admitted to the hospital for COVID-19. During the start of the pandemic they had new cases of hyperglycemia or high blood sugar levels. They also had worse results.
“These people weren’t diabetic before,” says lead author Paolo Fiorina, MD, Ph.D., affiliated with the Division of Nephrology at Boston Children’s Hospital. “But on admission, about 46% of the patients were found to have new hyperglycemia.” Although most cases resolved, approximately 35% of patients with recent hyperglycemia remained that way for at least six months after infection.
COVID-19: Hyperglycemia persisted beyond infection
The study evaluated the health of 551 people admitted to hospital in Italy from March to May 2020. A follow-up period included six months after hospital admission.
Compared to patients with no signs of glucose abnormalities, hyperglycemic patients also had worse clinical concerns:
- Longer hospitalizations
- Worst clinical symptoms
- An increased need for oxygen
- Greater need for ventilation
- More need for intensive care treatment
“We wanted to understand the mechanism by which these patients were underperforming compared to those without hyperglycemia.”
Says Fiorina, who published a previous article showing that COVID-19 worsened glycometabolic control in diabetics. The current study was published in Nature Metabolism.
Hormones also unbalanced
For more information, to all patients They were fitted with a glucose sensor at the time of admission. Over time, the researchers detected many abnormalities in glucose metabolic control in hyperglycemic patients.
They also found that the hyperglycemic patients had abnormal hormone levels. “We found that they were very hyperinsulinemic; they produced too much insulin, ”says Fiorina. They also had abnormal levels of proinsulin, a precursor to insulin, and markers of altered islet beta cell function. Islet beta cells produce and secrete insulin.
“Basically, the hormonal profile suggests that endocrine pancreatic function is abnormal in those patients with COVID-19 and persists long after recovery,” he says.
Inflammation from excess cytokines
Hyperglycemic patients also had severe abnormalities in the amount of inflammatory cytokines, including IL-6 and others.
“We think that blocking IL-6, and potentially even other cytokines, would be a benefit for beta cell function,” adds Fiorina, whose theory turned out to be true. Patients treated with anti-IL-6 therapy (tocilizumab), had a greater improvement in glycemic control compared to those who did not receive the medication.
A Next Wave of Diabetic Patients?
While glucometabolic abnormalities decreased over time in some patients, particularly after COVID-19 infection, others remained. Many patients had higher postprandial (after eating) glucose levels and abnormal pancreatic hormones in the post-COVID-19 period.
“This study is one of the first to show that COVID-19 has a direct effect on the pancreas,” says Fiorina.
“It indicates that the pancreas is another target of the virus that affects not only the acute phase during hospitalization, but also potentially the long-term health of these patients.”
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