Covid-19 could be cause of new form of diabetes, doctors say

Growing evidence suggests Covid-19 could cause diabetes – and may even induce an entirely new form of the disease – in survivors of the virus

Forty per cent of Covid-19 deaths in the UAE have been linked to diabetes, the latest government figures show. The National

Global health experts say there is growing evidence that Covid-19 could cause diabetes.

Doctors are even considering the possibility that the coronavirus could induce an entirely new form of the disease.

The link was made after medics noticed new cases of both Type 1 and Type 2 diabetes in people who had Covid-19 early in the pandemic.

Researchers have since followed the recovery of thousands of people who spent time in hospital after developing complications of the virus, and found they were more likely to be diagnosed with the condition.

About 5 per cent of 47,000 people in England who were admitted to hospital as a result of the virus went on to develop diabetes, a chronic high blood sugar condition.

They were 1.5 times as likely to receive a diagnosis of the disease, said the charity Diabetes UK.

Research from five inpatient units in the UK between last March and June found diagnoses of Type 1 diabetes were also higher in children.

Coronavirus in the UAE:

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  A medical worker puts away a Covid-19 swab test at one of the Mussaffah testing facilities. Victor Besa / The National

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  An Abu Dhabi resident goes for a jog along the Corniche in the capital as the government eases movement restrictions. Victor Besa / The National

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  Abu Dhabi residents wear mandatory masks as they walk in the city. Victor Besa / The National

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  Safety instructions are on display outside Al Awir fruit and vegetable market in Dubai. Pawan Singh / The National

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  A person wearing protective face mask and covering his face with laptop bag on a hot day in Bur Dubai area in Dubai. Pawan Singh / The National

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  Indian citizens queue to check in at the Dubai International Airport before leaving the UAE on a flight back to their home country on May 7. Inbound flights for UAE residents have also begun operating from select cities. Karim Sahim / AFP

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  Passengers from an Emirates flight from London queue before being checked by health workers at Dubai International Airport on May 8. Karim Sahib / AFP

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  Al Wahda Mall in Abu Dhabi has reopened to the public but with safety measures in place to protect shoppers and staff from contracting Covid-19. Victor Besa / The National

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  Yas Mall in Abu Dhabi has reopened to the public from 12pm to 9pm. Measures remain in place to keep shoppers and staff safe. Victor Besa / The National

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  Yas Mall in Abu Dhabi will be open from midday to 9pm. Supermarkets and pharmacies will be open from 9am to midnight. Victor Besa / The National

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  Workers pass by Al Mina vegetables and fruits market in Abu Dhabi. Victor Besa / The National

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  A security guard is given a free Covid-19 test at one of the Mussaffah testing centres. Victor Besa / The National

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  Workers line up to receive a coronavirus test at the Mussaffah industrial area in Abu Dhabi. Victor Besa / The National

"In comparison with a typical year, we estimate this represents an additional 12-15 new type 1 diabetes cases [80 per cent increase] during the Covid-19 pandemic, with apparent clusters of cases observed in two units," the authors wrote in the journal Diabetes Care.

“While our data does not prove a link, we postulate that Sars-CoV-2 exposure contributed to the observed increase in cases by precipitating or accelerating type 1 diabetes onset.”

Researchers do not know yet why it is happening.

But they suspect it may be related to Ace-2 proteins, which the coronavirus uses to enter our cells all over the body.

The receptors are found in the pancreas, which maintains the body’s blood sugar balance.

Research shows the virus can invade and spread in pancreas cells.

“When coronavirus ‘locks on’ to Ace-2, our pancreas cells might not be able to do their normal jobs of releasing insulin and processing glucose,” researchers at Diabetes UK said.

“It is possible that this could accelerate progression towards Type 2 diabetes or bring already existing Type 2 diabetes to light.”

Experts think it could also be causing a new form of the condition by changing the way insulin-producing cells work when they invade Ace-2 proteins, in the pancreas.

“The evidence to suggest coronavirus could cause type 1, type 2 – or even a new type of diabetes – is growing but there’s still a lot we don’t know,” Diabetes UK said.

If Covid-19 does cause diabetes, it will not be the only virus with the ability to do so.

Extensive research has shown those who suffer an enterovirus infection are at increased risk of developing Type 1 diabetes.

Enteroviruses cause a range of similar symptoms to those of coronaviruses, including fever, runny nose, sneezing, cough and body aches.

And like Sars-CoV-2, the virus has been found in the pancreas.

“We can’t yet be sure if coronavirus is directly causing any new cases of diabetes, or whether there are other factors that could explain the link,” Diabetes UK said.

Many doctors do believe there is a link.

A registry has been established to record new cases of diabetes among those who had Covid-19.

Professor Francesco Rubino, chairman of metabolic and bariatric surgery at King’s College London, set it up to track new cases of the condition.

"Over the last few months, we've seen more cases of patients that had either developed diabetes during the Covid-19 experience, or shortly after that. We are now starting to think the link is probably true – there is an ability of the virus to cause a malfunctioning of sugar metabolism," Prof Rubino told The Guardian newspaper.

“We said it’s worth embarking on an investigation because this – especially given the size of the pandemic – could be a significant problem.”

Diabetes patients at risk of more severe infections

At 16.3 per cent, the UAE has one of the world’s highest prevalence rates of diabetes, according to a report from the International Diabetes Federation in 2019.

About 40 per cent of Covid-19 deaths in the UAE’s first wave were linked to diabetes, according to the figures released last year.

Dr Hesham Abuelsaoud, an endocrinologist at NMC Royal Hospital in Khalifa City, Abu Dhabi, said long-standing diabetes impairs innate immunity, leaving sufferers more susceptible to infections.

“Innate immunity is the first line of defence against any infection, especially viral infections such as Covid-19,” he said.

“The problem people with diabetes face is they’re more likely to have worse complications if they get it, not a greater chance of getting the virus.

“Viral infections can also increase inflammation, or internal swelling, in people with diabetes. This can also be caused by above-target blood sugars, and that inflammation could contribute to more severe complications.”