Mild illness seems to increase the risk of diabetes

/Robert Kneschke, stockadobecom

Düsseldorf – Even a mild illness with COVID-19 could increase the risk of type 2 diabetes. This is indicated by an evaluation of family doctor patients from Germany Diabetology (2022; DOI: 10.1007/s00125-022-05670-0) there.

Previous studies have shown that the pancreatic beta cells can be damaged when infected with SARS-CoV-2, which in the worst case could result in type 1 diabetes. In addition, the inflammatory response that occurs in COVID-19 appears to reduce insulin sensitivity, which could increase the risk of type 2 diabetes. The sedentary lifestyle enforced in lockdown could further increase the risk.

In fact, in recent months there have been numerous reports of patients newly diagnosed with diabetes after COVID-19. Whether these are isolated cases or whether a wave of new cases is imminent in the shadow of the pandemic is currently the subject of epidemiological investigations.

A team led by Wolfgang Rathmann from German Diabetes Center in Düsseldorf evaluated the “Disease Analyzer” database, which includes a representative sample of general practitioner patients. As of January 2021, 35,865 patients had contracted COVID-19. The epidemiologists compared them with the same number of patients who were being treated for upper respiratory diseases but who were not infected with SARS-CoV-2.

The analysis showed that 189 COVID-19 patients developed type 2 diabetes in the first 365 days. In the control group there were 175 diseases. The incidences were 15.8 versus 12.3 new cases per 1,000 people per year. Prof. Rathmann determined a relative incidence rate (IRR) of 1.28, which was significant with a 95% confidence interval of 1.05 to 1.57. This means there is a 28% increased risk of developing type 2 diabetes after mild COVID-19 (treated by GPs).

Patients and controls were similar in a number of factors that could affect outcomes. These included gender, age, health insurance coverage, index month, and comorbidity (obesity, hypertension, hyperlipidemia, myocardial infarction, stroke). However, there was no precise information on the body mass index (BMI), which general practitioners in Germany do not regularly record in the medical records. It can therefore not be completely ruled out that there are other reasons for the diabetes.

The topic is currently occupying diabetologists in various countries. The international CoviDiab-Register collects cases of illness from all over the world. It also addresses the question of whether COVID-19 can trigger type 1 diabetes by destroying beta cells. There were only a few diseases in the “Disease Analyzer” database, so that Prof. Rathmann was unable to carry out any calculations. © rme / aerzteblatt.de

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