Potential metabolic and inflammatory pathways between COVID-19 and new-onset diabetes

Newly diagnosed diabetes in patients with mild to moderate COVID-19

“…COVID-19 infection in people with diabetes (including newly diagnosed diabetes) can cause marked hyperglycemia through several complex but inter-related factors. These include, but are not limited to, the inflammatory response triggered by the virus and subsequent release of counterregulatory hormones, activation of the renin-angiotensinogen system, and destruction of pancreatic β cells by the virus itself or by the cytokines triggered by the virus [ 8 , 9 ].…”

Is newly diagnosed diabetes as frequent as preexisting diabetes in COVID-19 patients?

“…Preexisting diabetes is a common comorbidity in coronavirus disease 2019 (COVID-19) patients [ [1] , [2] , [3] ]. Intriguingly, recent reports show that newly diagnosed diabetes is also frequently observed in these patients [ 4 , 5 ]. However, it is not known how the frequency of newly diagnosed diabetes compares with that of preexisting diabetes in COVID-19 patients.…”

“…The reasons behind this intriguing finding are not known. COVID-19 virus may cause new-onset diabetes or unmask previously undiagnosed diabetes by injuring pancreatic β-cells, interfering with the insulin signalling pathways, or activating the renin-angiotensin system [ 5 ]. Newly diagnosed diabetes may also result from the increase in counterregulatory hormones (e.g., cortisol) and cytokines in response to the stress associated with severe illness or treatment with glucocorticoids [ 4 , 5 ].…”

What is the role of admission HbA1c in managing COVID‐19 patients?

“…Newly diagnosed diabetes (new onset or previously undiagnosed) is now increasingly recognized as a common phenomenon in COVID-19 patients. 15,16 More importantly, COVID-19 patients with newly diagnosed diabetes appear to be at a greater risk for poor prognosis not only compared with those without diabetes but also individuals with known diabetes. [17][18][19] To summarize, admission blood glucose is certainly a key biomarker to risk stratify and guide the clinical management of COVID-19 patients, with or without known diabetes.…”

“…15,20 These patients are a high-risk group and should be closely monitored for the emergence of cardiometabolic disorders in the long term. 16 ACKNOWLEDGEMENTS No funding received.…”