New onset diabetes mellitus in post-COVID-19 patients

Abstract

Background: Diabetes, is known to have a bilateral relationship with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Precise mechanism of diabetes onset in COVID-19 patients remains unclear. Aim: To analyse the incidence of new onset diabetes (NODM) among COVID-19 patients, as well as the effect of body mass index (BMI), family history, and steroid use on the incidence of the disease. Methods: Adult, not known diabetic patients, tested positive with Rapid Antigen Test or RT-PCR admitted to a tertiary care hospital and research institute were included in the present prospective observational study. The patients who developed NODM and NOPD (New Onset Pre-diabetes) during the three months follow-up and the risk factors associated were assessed. Patients with HbA1c >6.4% were diagnosed with NODM. An HbA1c of 5.7% to 6.4% was used to characterize NOPD. Results: Out of 273 previously not known diabetic COVID-19 infected individuals, a total of 100 were studied for three months after consent. Mean age of the patients 48.31 ± 19.07 years with male predominance (67%). Among these, 58% were non-diabetics and 42% were pre-diabetics. 6 (10.3%) of the 58 non-diabetics developed NOPD, and 8 (13.8%) developed NODM. 6 (14.2%) of the 42 pre-diabetics became non-diabetic, and 16.6% (7) developed NODM. Family history of DM ( P < 0.001), severity at admission ( P < 0.006), diabetic ketoacidosis ( P < 0.0275), and persistent symptoms were associated significantly with NODM. Those with NODM had significantly greater BMI, O 2 duration, steroid duration, FBS, and PPBS ( P < 0.001 for all). Nearly 67% of the patients who developed NOPD had shortness of breath as the common symptom at time of admission ( P = 0.0165). Conclusion: The incidence of NODM was strongly influenced by positive family history of DM, higher BMI, steroid dosage, and its duration. Hence, patients with COVID-19 need to be under surveillance for blood glucose screening.

Is COVID-19 incriminated in new onset type 2 diabetes mellitus in Lebanese adults?

“…According to the results obtained from our study, higher Body Mass Index (BMI) was associated with higher odds of developing NODM post COVID-19, corroborating previous results [ 13 ]. This emphasizes obesity as a traditional risk factor for diabetes mellitus development in individuals without prior COVID-19 infection and additionally increasing the risk of NODM post COVID-19 infection.…”

“…It is known that Diabetes Mellitus Type 2 is associated with different viral infections (e.g. Influenza, Dengue…), which is also an evidence that COVID-19 could also be associated with new onset of diabetes [ 13 ]. The mechanisms suggested for the development of Diabetes Mellitus post COVID-19 infection are (1) either by the affinity of the virus to bind to target cells and therefore modifying the normal function of pancreatic cells (i.e.…”

New-Onset Diabetes Mellitus in COVID-19: A Scoping Review

“…Keerthi et al evaluated 100 patients with COVID-19 and discovered that new-onset DM (NODM) was associated with a family history of DM ( p < 0.001), higher BMI ( p < 0.001), duration of need for supplemental oxygen or parenteral steroids ( p < 0.001), the severity of infection at the time of admission ( p = 0.006), and diabetic ketoacidosis ( p = 0.0275). Moreover, 10.3% of patients without diabetes developed new-onset prediabetes (NOPD), and 13.8% developed NODM, while 16.6% of patients with prediabetes advanced to NODM [ 26 ].…”

“…Similar results came from a Korean cohort study including 348,180 patients diagnosed with COVID-19 from January 2020 to September 2021 [ 29 ]. Likewise, in Canadians [ 26 ], Choi et al found that COVID-19 is associated with a greater risk for newly diagnosed DM (aHR 1.30; 95% CI 1.27–1.33), and this risk is in proportion with the COVID-19 severity, so patients admitted to the ICU presented the highest risk (aHR 1.78, 95% CI 1.59–1.99) [ 29 ].…”

The prevalence of pre-diabetes and diabetes in people with and without past history of COVID-19 in northeastern Nigeria

“…Potential mechanisms include a direct impact on pancreatic beta cells, which may compromise insulin secretion (4)(5)(6). Other factors, such as steroid therapy in the management of COVID-19 infection, have also been implicated in the pathogenesis of post-COVID-19 diabetes (3,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”