New-Onset Diabetes Mellitus Presenting As Diabetic Ketoacidosis in Patients With COVID-19: A Case Series

Sarwani, Aysha Asif; Saeed, Mahmood Al; Husain, Taha; Fardan, Rawdha M Al

doi:10.7759/cureus.16290

Cited by 8 publications

(8 citation statements)

References 23 publications

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“…21 In terms of morbidity and mortality, a previous case series reported that most cases of new-onset diabetes concurrent with COVID-19 infection show positive outcomes. 22 Similar results were found in our data except for one patient who developed multiorgan failure and died; however, this may be more related to the advanced age of the patient, the extended bilateral pneumonia and other complications such as heart and kidney failure rather than the hyperglycaemic decompensation.…”

Section: Discussionsupporting

confidence: 90%

Clinical/biochemical characteristics and related outcomes in people with new‐onset diabetes and COVID‐19: experience from a single centre

et al. 2022

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Aims: It is known that there is a bidirectional relationship between diabetes mellitus (DM) and coronavirus disease (COVID‐19). It has been described that those patients infected with SARS‐CoV‐2 could develop severe metabolic decompensation of pre‐existing or new‐onset DM, although diabetogenic effect of SARS‐CoV‐2 has still not been well consolidated. In fact, the coexistence of SARS‐CoV‐2 infection and new‐onset DM is an infrequent situation. Methods: We describe the clinical and analytical characteristics of 19 patients admitted to a Spanish tertiary hospital – all 19 having COVID‐19 infection and new‐onset DM. Results: 12/19 patients (63.2%) were female; the mean age at diagnosis of DM was 54 (39–65) years. The most frequent ethnic group was Caucasian (n=9), followed by Latin‐American (n=7); 7/19 (36.8%) previously met criteria for prediabetes due to altered basal glycaemia or HbA 1c . The mean BMI at diagnosis was 32.26kg/m 2 (27.62–35.18kg/m 2 ). Eighteen of 19 patients (94.7%) showed bilateral bronchopneumonia. The mean blood glucose of the first blood was 17.5mmol/L (11.1–21.1mmol/L), and the mean HbA 1c was 88mmol/mol (60–115mmol/mol). C‐peptide was requested in eight patients and it was within normal range in 87.5% (n=7) and below the inferior threshold in one case. Autoantibodies were requested in 26.3% (five patients), being negative in 4/5 (80%) and positive in 1/5 (20%). Regarding the type of diabetes diagnosed, 18 were type 2 DM and only one case was diagnosed with type 1 DM. Seventeen had simple hyperglycaemia and two suffered a diabetic ketoacidosis. The mean HbA 1c at 8.0 months (5.0–12.0 months) follow‐up was 42mmol/mol (40–49mmol/mol). Conclusion: The majority of those described had type 2 DM that appears to have been unmasked by the COVID‐19 infection, since they had high HbA 1c and several risk factors for diabetes development, such as obesity and prediabetes. Most of them had their pancreatic reserve preserved, and this may suggest insulin resistance as the aetiology rather than direct beta‐cell damage. A good evolution of diabetes after hospital discharge was observed in the patients followed up at our centre. Copyright © 2022 John Wiley & Sons.

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Section: Discussionsupporting

confidence: 90%

Clinical/biochemical characteristics and related outcomes in people with new‐onset diabetes and COVID‐19: experience from a single centre

et al. 2022

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“…In a case series from Bihar, young, non-diabetic individuals presented to hospital within one month post-COVID infection, with fatigue, polydipsia, polyuria and weight loss and were diagnosed with NODM and DKA. [ 24 ] Also, ADA states that polyuria, polydipsia, weight loss, polyphagia are symptoms of diabetes. [ 10 ]…”

Section: Discussionmentioning

confidence: 99%

New onset diabetes mellitus in post-COVID-19 patients

Keerthi

Sushmita

Khan

et al. 2022

Journal of Family Medicine and Primary Care

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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.

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“…Hyperglycemia, suppressed immunity, thromboembolic events and sepsis/septic shock are important pathogenic mechanisms involved in causing AKI in DM. [19][20][21] DM itself is an independent risk factor for AKI in general population.…”

Section: A H E a D O F P R I N Tmentioning

confidence: 99%

The Frequency and Risk Factors for Acute Kidney Injury in patients with COVID-19

et al. 2022

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Objective: To determine the frequency of Acute Kidney Injury (AKI) and its underlying risk factors in patients with Coronavirus Disease (COVID-19). Methods: This retrospective study was conducted by reviewing the medical records of patients admitted in Covid-19 Intensive Care Unit (ICU) of Farooq Hospital, West Wood Branch, Lahore during the period from 1st April, 2020 to 30th June, 2020. COVID-19 was diagnosed on basis of Real Time Polymerase Chain Reaction (RT-PCR) through nasal swab. Demographic, clinical and laboratory data were collected at the time of admission in the hospital. AKI was diagnosed on basis of ≥ 0.3 mg/dl increase in serum Creatinine (sCr) from baseline during the hospital stay. The outcome of study was AKI. Results: One hundred and seventy-six patients who fulfilled the inclusion criteria were recruited of which most were males (78.4%). The mean age was 51.26 ± 15.20 years and the frequency of AKI was 51.1%. The risk factors for AKI were increasing age (OR=2.10, p=0.017); presence of COVID-19 symptoms (OR=6.62, p=0.004); prolonged hospital stay (OR=2.26, p=0.011); Diabetes Mellitus (OR=1.81, p=0.057); hypoxemia (OR=5.98, p=0.000); leukocytosis (OR=2.91, p=0.002); lymphopenia (OR=5.77, p=0.000); hypoalbuminemia (OR=4.94, p=0.000); elevated C-reactive protein (CRP) (OR=6.20, p=0.000) and raised D-diamers (OR=3.16, p=0.000). Conclusions: AKI was present in half of the COVID-19 patients. The most significant risk factors for AKI were increasing age, prolonged hospital stay, hypoxemia, hypoalbuminemia, DM and raised inflammatory markers. doi: https://doi.org/10.12669/pjms.38.4.4980 How to cite this:Anees M, Farooq O, Raza M, Mumtaz A. Frequency and Risk Factors for Acute Kidney Injury in patients with COVID-19. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.4980 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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New-Onset Diabetes Mellitus Presenting As Diabetic Ketoacidosis in Patients With COVID-19: A Case Series

Cited by 8 publications

References 23 publications

Clinical/biochemical characteristics and related outcomes in people with new‐onset diabetes and COVID‐19: experience from a single centre

Clinical/biochemical characteristics and related outcomes in people with new‐onset diabetes and COVID‐19: experience from a single centre

New onset diabetes mellitus in post-COVID-19 patients

The Frequency and Risk Factors for Acute Kidney Injury in patients with COVID-19

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