- Nikolai Voronin
- Science Correspondent
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Type 1 diabetes is referred to as “children’s diabetes” in the medical community because it is usually diagnosed in childhood.
Infection with coronavirus significantly increases the risk of developing diabetes in a patient, and literally within a couple of weeks after the first symptoms of Covid-19 appear. This risk is especially high in children under 18 years of age.
This conclusion is contained in several studies on this topic, conducted by scientists from the United States and a number of other countries.
The authors of one of them calculatedthat only in the first months of the epidemic, out of the total number of patients hospitalized with suspected coronavirus in China, Italy and USA almost every seventh patient was diagnosed with diabetes for the first time during the treatment of covid.
In children infected with coronavirus, according to the latest data from the US Centers for Disease Control and Prevention (CDC), the risk of developing diabetes within the next month after infection increases more than 2.5 times.
Elevated blood sugar is one of the common symptoms of post-coronavirus syndrome (PCS), better known as “long covid” – when the symptoms that appeared as a result of infection with Covid-19 stretch for several months after the infection.
Most academic experts have so far refrained from answering the question of how great the chances of such patients for a full recovery are, but medical practitioners say they are aware of such cases.
Diabetes mellitus – and diabetes mellitus
Numerous scientific papers from around the world have long and very convincingly demonstrated the connection between coronavirus and diabetes mellitus – both type 1 and type 2. Moreover, this relationship is two-way.
The fact that the presence of diabetes in a patient (as well as other metabolic disorders, including overweight) in the event of infection with Covid-19 immediately puts him at risk and greatly worsens the medical prognosis, became obvious in the first months of the pandemic.
Now the feedback is becoming more and more clear: the coronavirus can provoke the patient to develop diabetes during infection.
What is diabetes?
Diabetes mellitus is the common name for several diseases of non-infectious origin (that is, they cannot be infected from a sick person). They are united by a common main symptom: due to problems with the absorption of glucose in the blood, the level of sugar rises greatly.
Accumulating glucose, the blood thickens, due to which, sooner or later, vessels begin to be damaged, especially the thinnest capillaries (for example, in the eyes, which can lead to blindness).
However, despite the similarity of symptoms, the diseases have completely different origins – and, accordingly, require a different approach to treatment.
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Many diabetics have to measure their blood sugar levels 4-6 times a day.
Type 1 diabetes (T1D) is an autoimmune disease in which the patient’s immune system malfunctions for some reason. As a result, the body begins to produce antibodies that destroy the pancreatic beta cells that produce insulin, a hormone needed to process consumed carbohydrates.
In the medical community, the disease is known as “children’s diabetes” because it usually occurs in childhood, and the disease develops rapidly. Literally within a couple of weeks, the production of insulin completely stops, and the patient has to control the level of glucose in the blood for the rest of his life by subcutaneous injections of the hormone.
Type 2 diabetes (T2D) is usually preceded by a rather long, often years-long process”prediabetes“. Due to the lack of physical activity and the increased fat content, the patient’s tissues begin to react worse and worse to the release of insulin into the blood. That is, the hormone itself is there, and in large quantities, but the body does not seem to notice or recognize it. In Russia, from suffering from this disorder almost every fifth.
The medical term for this disorder is “obese diabetes” or “overweight diabetes” and the process – unlike T1D – can be reversed. You can return sugar to normal with the help of pills, but the main thing is to switch to a healthier and more active lifestyle.
The risk of getting sick is significantly higher for those who carry the infection in a severe form that requires hospitalization. However, cases of diabetes mellitus after a mild course of coronavirus have also been recorded, and even in those who have had Covid-19 infection asymptomatically.
By the fall of 2020, at least a dozen articles had been published in reputable scientific journals, the authors of which – mostly practicing clinicians – drew attention to a suspicious coincidence: in the blood of most patients admitted to the hospital with covid, glucose levels were much higher than normal – regardless of age and other factors.
In general, this is a fairly standard body reaction to ongoing inflammation – including in the most healthy (otherwise) people. However, in the case of covid, not all patients managed to return sugar to normal.
An analysis of the scientific literature showed that within a month after the onset of the first symptoms of Covid-19, diabetes develops in almost every seventh hospitalized patient (14.4%).
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In Britain, diabetics – as one of the largest risk groups – were among the first to be vaccinated
Pediatricians are especially concerned about this fact. According to the U.S. Centers for Disease Control and Prevention (CDC), covid infection in a minor child significantly increases the risk development of diabetes in the next month (according to some estimates – 2.6 times).
Dangerous “stash” and cautious optimism
Candidate of Medical Sciences, Moscow endocrinologist Anna Nevolnikova says that such a mass detection of diabetes in coronavirus patients does not surprise her at all. There may be several reasons for this.
Firstly, on the surface of insulin-producing pancreatic cells there is the same ACE2 receptor through which the virus enters – that is, they are an easy target.
Secondly, during the pandemic, people in general began to eat significantly more and move less. In addition, in the face of uncertainty and isolation, many have lost even the motivation to take care of their health. A significant role, according to Nevolnikova, could be played by the level of stress.
“Glucose for the body is like money, and any crisis is easier to survive when you have a stash,” the expert explains. “During stress, when the body is afraid of a lack of energy (and glucose is just an easy source of fast energy for cells), we have dramatically increased levels of hormones that increase glucose levels and reduce the body’s sensitivity to its own insulin.”
Thirdly, patients admitted to the hospital with coronavirus are often prescribed drugs that also increase blood sugar levels, causing the so-called steroid diabetes.
Fourth, the notorious “cytokine storm” – when the raging immune system of some (genetically predisposed) patients begins to destroy their own organs – always reduces the body’s susceptibility to insulin and increases the load on the pancreas as a whole.
However, according to Nevolnikova, the newly minted “covid diabetics” have a hope for recovery – at least partial.
“I have had many such cases when, after covid, the patient’s sugar level is very high, and you prescribe him insulin. But then the doses are needed less and less, and at some point you transfer the patient to pills,” she assures. Such cases do happen, and there are many of them.