COVID-19–Induced New-Onset Diabetes: Trends and Technologies

Abstract

The coronavirus disease 2019 global pandemic continues to spread worldwide with approximately 216 million confirmed cases and 4.49 million deaths to date. Intensive efforts are ongoing to combat this disease by suppressing viral transmission, understanding its pathogenesis, developing vaccination strategies, and identifying effective therapeutic targets. Individuals with preexisting diabetes also show higher incidence of COVID-19 illness and poorer prognosis upon infection. Likewise, an increased frequency of diabetes onset and diabetes complications has been reported in patients following COVID-19 diagnosis. COVID-19 may elevate the risk of hyperglycemia and other complications in patients with and without prior diabetes history. It is unclear whether the virus induces type 1 or type 2 diabetes or instead causes a novel atypical form of diabetes. Moreover, it remains unknown if recovering COVID-19 patients exhibit a higher risk of developing new-onset diabetes or its complications going forward. The aim of this review is to summarize what is currently known about the epidemiology and mechanisms of this bidirectional relationship between COVID-19 and diabetes. We highlight major challenges that hinder the study of COVID-19-induced new-onset of diabetes and propose a potential framework for overcoming these obstacles. We also review state-of-theart wearables and microsampling technologies that can further study diabetes management and progression in new-onset diabetes cases. We conclude by outlining current research initiatives investigating the bidirectional relationship between COVID-19 and diabetes, some with emphasis on wearable technology. Coronavirus disease 2019 (COVID-19) is a global pandemic responsible for approximately 216 million confirmed cases and 4.49 million deaths that continues to spread rapidly (1). The virus responsible for COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China, in 2019 and spreads via droplet transmissions, leading to variable symptoms that can range from asymptomatic or mild respiratory illness to severe multiorgan failure and death in infected individuals. Individuals with type 1 diabetes (T1D) or type 2 diabetes (T2D) often have comorbidities such as hypertension, obesity, and cardiovascular disease (2), all of which have also been implicated in increased susceptibility to and mortality from COVID-19 infection (3). Similar to the SARS-CoV-1 outbreak in 2003 (4) and respiratory syncytial virus infection (5), there is an increase in hyperglycemic conditions and complications in COVID-19 patients both with and without diabetes. Specifically, new-onset diabetes has been observed following COVID-19 infection (6), including acute hyperglycemia in COVID-19 patients without diabetes, diabetic ketoacidosis in COVID-19 patients with preexisting diabetes, and newonset diabetes in 8).Given the evolving nature of the COVID-19 pandemic, it is not yet known whether new-onset SARS-CoV-2-induced diabetes occurs via established mechanism...

SARS-CoV-2 infection impairs the insulin/IGF signaling pathway in the lung, liver, adipose tissue, and pancreatic cells via IRF1

“…Insulin/IGF signaling plays a central role in the regulation of systemic energy homeostasis [14] , [15] . Emerging studies have shown that COVID-19, in some cases, predisposes patients to develop metabolic complications during or after the recovery process, such as insulin resistance, hyperglycemia, hyperlipidemia, and new onset of diabetes [13] . In the present study, we showed that SARS-CoV-2 infection caused impairment of the insulin/IGF signaling pathway in important metabolic tissues and endocrine cells ( Fig.…”

“…Approximately 5 % of infected people progress to serious stages with respiratory failure, septic shock, and acute respiratory distress syndrome (ARDS) [2] . The infection causes host cell and tissue damage and, in some cases, it triggers metabolic abnormalities, such as insulin resistance, hyperglycemia, abnormal lipid control, abnormal amino acid control, and new onset of diabetes [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] . However, the molecular mechanisms have not yet been fully explained.…”

Newly developed type 1 diabetes after coronavirus disease 2019 vaccination: A case report

“…Because patients diagnosed with COVID‐19 have been reported to develop diabetes more frequently and might be at increased risk for hyperglycemia, 9 vaccines that produce virus‐like proteins could similarly make recipients develop or exacerbate diabetes, and have recently been reported to worsen glycemic control. 5 , 6 , 7 , 8 Although most of the cases concluded to be the onset or exacerbation of type 2 diabetes occurred early after the first or second vaccination, 5 , 6 , 7 the diagnosis of type 1 diabetes took a relatively long period (4–8 weeks) after the second vaccination, including the previously reported 8 case as well as the present case.…”

A comparative study on the clinical profile of COVID-related and non-COVID-related acute invasive fungal rhino sinusitis

“…Uncontrolled DM remained the most common co-morbidity in both the groups of the current study. Some of the recent studies have implicated COVID-19 infection in the genesis or worsening of hyperglycemia [ 12 , 13 ]. In the non-COVID group, all patients were long-term diabetics, except one case of freshly detected DM.…”