A cohort of scientists from across the world believe that there is a growing body of evidence that COVID-19 can cause diabetes in some patients, reports The Guardian. Professor Francesco Rubino, from King’s College London, is leading the call for a full investigation into a possible link between the two diseases. Having seen a rise in both type 1 and type 2 diabetes in people who have caught coronavirus, some doctors are even considering the possibility that the virus ‒ by disrupting sugar metabolism ‒ could be inducing an entirely new form of diabetes.
Rubino first realised the possibility of a link during a tea party with colleagues over Zoom where anecdotal cases were being exchanged.
Rubino and others set up a registry to start pooling and analysing these reports. The principal investigators of the registry which has received reports from more than 350 individual clinicians who suspect they have encountered one or more cases of COVID-induced diabetes – have said the numbers were hard to ignore.
“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,” said Rubino.
If there was a biological link, it would be difficult to prove without a substantial database, he noted. “We said it’s worth embarking on an investigation because this – especially given the size of the pandemic – could be a significant problem.”
The Guardian reports that patients with pre-existing diabetes have a higher risk of serious complications with COVID-19 and are on the UK priority list to receive the vaccine. Links between other viruses and diabetes, and the way the Sars-CoV-2 virus that causes COVID-19 penetrates multiple organs has triggered concern.
“In my own mind, there’s no doubt. COVID-19 is certainly a cause of new diabetes,” said Paul Zimmet, professor of diabetes at Australia’s Monash University. “But we don’t yet fully understand – firstly, the magnitude and, secondly, which of the things that we’ve hypothesised are the major factors.”
Scientists have hypothesised that since Sars-CoV-2 interacts with a receptor called ACE-2 to infiltrate cells in a range of organs, including the pancreas, it could be disrupting the sugar metabolism. Another potential explanation is the body’s exuberant antibody response, which is meant to fight the virus, over-reacts and attacks the organs key to maintaining normal glucose levels.
“Now, these are all theories … theories that are not philosophical but grounded in biology and experience with other viruses,” said Rubino, who is chair of metabolic and bariatric surgery, in the report.
An international group of diabetes researchers and clinicians have established a global database of new cases of diabetes in patients with COVID-19 – called the CoviDiab Registry Project. It comes off the back of initial observations that COVID-19 could potentially trigger diabetes and the urgent need to know more.
The goal of the registry is to collect data on people newly-diagnosed with diabetes and with confirmed COVID-19. It will also collect data on people with existing diabetes who present with COVID-19 and severe metabolic dysregulation, with the aim of investigating the pathogenesis of the interaction between the two conditions.
Ultimately, researchers hope to understand whether COVID-19 causes a new form of diabetes or more simply a stress response that triggers classic type 1 or type 2 diabetes.
The CoviDiab team are calling for healthcare professionals to contribute patient data to the registry.
The registry will be fully anonymised and researchers will have no access to patients’ personal identifiers. Data about clinical observations will be entered by clinicians that are members of the care team for the individual patient or by authorised research personnel when data are transferred from other research databases.
Full report in The Guardian (Open access)
Diabetes UK material