As we move forward in the wake of COVID-19 with an available vaccine, scientists will continue to study the long-term effects of the virus. Since then, several additional studies have linked COVID 19 to the development of new cases of type 1 diabetes during the pandemic.
Diagnosis of Type 1 Diabetes in Britain During SARS COV 2
In August 2020, Reuters reported on research from the Imperial College of London showing nearly a 200% increase in the prevalence of type 1 diabetes diagnoses during the COVID-19 epidemic in the UK. The news source stated that this small study was the first to associate new-onset of type 1 diabetes mellitus with COVID-19 cases.
According to the research, which was published in the journal Diabetes Care, 30 children at four London hospitals were diagnosed with type 1 diabetes during the pandemic’s peak in the city in April and May 2020. This represents about twice the number of cases seen during the same period in 2019. The team tested 21 of these children for the presence of coronavirus and found that five had an active infection.
In addition, 70% of the children in the study who were diagnosed with new-onset type 1 diabetes presented with diabetic ketoacidosis. DKA is a life-threatening complication of diabetes that occurs when insulin levels decline; left untreated, it can lead to dangerous blood acidity. The researchers noted that fewer children with new diabetes diagnoses had this complication in years prior to the pandemic.
While they stress that we need more research to determine whether COVID 19 may cause type 1 diabetes, the study authors theorize that the increase in protein caused by the virus could damage the pancreatic cells that create insulin, which mimics the action of immune cells in people who have type 1 diabetes. As a result, the body cannot process blood glucose, leading to dangerous potential complications for people who have this disease.
German Research on Asymptomatic COVID and Type 1 Diabetes
Researchers published a paper in the September 2020 issue of the journal Nature Metabolism about a 19-year-old who developed type 1 diabetes after a SARS COV 2 infection. The team from the University Medical Centre Schleswig-Holstein in Kiel, Germany reported that the man presented to the emergency room with high blood glucose levels and diabetic ketoacidosis about eight weeks after a positive test for COVID-19 antibodies. Although the antibodies signify that he was likely infected with coronavirus, he did not have symptoms.
Like the London team, the German researchers suspect that the virus causes similar damage to pancreatic function as the autoimmune damage that occurs in people with type 1 diabetes. The patient did not have the serum antibodies usually present in these diabetic patients, and the researchers indicate that he may have already been hyperglycemic when he presented to the emergency room with the DKA symptoms. Study authors also referred to an increase in the prevalence of diabetic ketoacidosis and hyperglycemia among people in Germany during the pandemic, even children and adolescents with no diabetes history.
Past research has associated other viral infections with the development of type 1 diabetes. The autoimmune disease has been linked to cases of flu, cytomegalovirus, mumps, rotavirus, and enterovirus in clinical studies, according to MedPage Today. Researchers in China and Italy, two of the countries that experienced the earliest impact of the pandemic, also report an increase in type 1 diabetes prevalence compared to numbers in previous years.
While no comprehensive research studies have linked coronavirus to the development of type 1 diabetes or any other autoimmune diseases, scientists will continue to conduct larger studies to inform policy that supports public health as we recover from the COVID-19 pandemic.
Tracking Complications After COVID-19 Infection
If you or a member of your family has had coronavirus, you should see your doctor if you develop unusual health symptoms in the weeks and months after the infection resolves. Rebecca Unsworth, one of the authors of the London study, said that parents should look for the “four Ts” of type 1 diabetes: thinner appearance (unexplained weight loss), toileting more often (frequent urination), thirst, and tiredness without an explanation.
Some children have even developed a dangerous complication called a multisystem inflammatory syndrome, or MIS-C. The Centers for Disease Control and Prevention calls MIS-C a rare complication of COVID that can cause a range of symptoms such as exhaustion, bloodshot eyes, nausea, diarrhea, vomiting, gut pain, and inflammation of the heart, kidneys, eyes, skin, brain, and lungs.
A version of MIS-C may also affect adults. The BBC reports that many UK residents who have had the COVID-19 virus develop a complication called chronic post-viral fatigue, which mimics the exhaustion that occurs with chronic fatigue syndrome.
Although we know little about long-term coronavirus recovery at this point, Harvard Health Publishing has identified a few areas of confidence for doctors. Thus far, people who had to be admitted to the hospital and spent time in intensive care for COVID-19 infection have a higher likelihood of long-term complications from the virus. Extended recovery will be necessary for individuals who developed the most serious lung complication, acute respiratory distress syndrome. Men, older adults, and Black and Latino adults also have a statistically higher risk for COVID-19 complications according to WebMD.
Managing Diabetes and COVID-19 Infection
Harvard Health Publishing reports that complications of coronavirus are more common among people who have pre-existing health conditions such as obesity, hypertension and diabetes. Doctors stress that targeted treatment to address damage to the pancreas and other organs represents an essential part of recovery for these COVID-19 survivors.
In the coming months, researchers will likely develop recommendations for post-coronavirus health screenings for people who have SARS COV 2, including those who have diabetes. In the meantime, doctors stress that individuals who have had the virus or been vaccinated continue to follow CDC health precautions such as wearing masks in public spaces, washing hands frequently, and getting a seasonal flu vaccine.
You should also review the information provided by the American Diabetes Association about diabetes and COVID. The ADA notes that you have an increased risk of serious illness from any virus, especially if you have another chronic condition such as heart disease in addition to diabetes. The organization also reports that while people who have type 1 diabetes may have a higher risk of COVID-19 than people who have type 2 diabetes, we need more research to support this information.
Review the signs of serious complications such as DKA and seek medical attention right away if you become ill. Emergency symptoms include blue-tinged skin and lips, the inability to fall asleep or be awakened once asleep, unexplained confusion, chest pressure or pain, shortness of breath, or difficulty breathing.
If you already have type 1 or type 2 diabetes and you contracted coronavirus, monitoring and controlling your blood glucose levels can help you stay healthy as you recover. You can also take self-management steps for good diabetes care such as exercising regularly and eating a healthy diet. Convenient home delivery of diabetes supplies from MedEnvios Healthcare keeps everything you need for self-management of diabetes at your fingertips.
Featured Image: Eviart/Shutterstock