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Does COVID-19 cause diabetes? Here's what experts are saying

A number of studies are showing a potential link between the virus and a rise in type 2 diabetes cases.

CLEVELAND — The latest study just released in the Journal of Pediatrics found type 2 diabetes cases among American youth jumped 77% during the first year of the pandemic compared to the previous two years. It mainly happened in the southern and western regions of the country.

The research team at Johns Hopkins Children’s Center went over records of more than 3,000 children newly diagnosed with type 2 diabetes between March 2018 and February 2021.

Research showed new diagnoses of type 2 diabetes rose by 77% during the first year of the pandemic. A total of 825 cases were identified on average in the two pre-pandemic years compared with 1,463 in the first year of the pandemic.

What happened that first year? In addition to COVID infections, schools were closed, sports were sidelined, kids had more screen time and less physical activity and likely didn’t get adequate sleep and eat a healthy diet. Those factors could have easily contributed to the rise in type 2 cases.

Another study released earlier this year in The Lancet Diabetes & Endocrinology from researchers at the VA St Louis Healthcare System, looked at the medical records of more than 180,000 people who survived more than a month after a COVID infection.  

Those records were compared with records from two other groups, each of which comprised around four million people without SARS-CoV-2 infection who had used the VA health-care system, either before or during the pandemic.

They found people who had COVID infections, even mild cases, were about 40% more likely to develop diabetes up to a year later than veterans in the control groups.

The chance of developing diabetes rose if the COVID infection was more severe. People who were hospitalized or admitted to the ICU had nearly a triple risk compared to those who did not have COVID.

Currently there is no definite proof that COVID causes diabetes. More study is definitely needed. But the association is concerning and there are several theories as to why there seems to be a connection. 

One is statistics.

  • 90% of the 88 million with pre-diabetes don't know they have it and they are more likely to progress to type 2.
  • 25% of the 34 million with diabetes have yet to be diagnosed. 

Its possible more cases are being reported because long-haulers are receiving more frequent medical care.  

But can COVID cause diabetes?

Dr. Kathleen Wyne, of The Ohio State University Wexner Medical Center, who wrote about this issue last year, suggested that acute stressors, such as inflammation from cytokine activation often seen in COVID patients can cause hyperglycemia, or high blood sugar, in someone not known to have diabetes/prediabetes. 

Other experts think the person may have a genetic risk, be slightly overweight and sedentary. But the combination of the insulin resistance from the acute COVID infection and the high-dose steroids used to treat it might cause a significant insulin increase that the pancreas isn’t ready to handle.

Dr. Abhijit Duggal, critical care specialist for Cleveland Clinic, said more research still needs to be done to understand why that is.

“In scientific terms, what we usually say is we have shown an association, we have not shown any causation, said Dr. Duggal. “So this is something we are seeing that kind of goes hand in hand, but we cannot prove right now that this is the cause of diabetes itself,” Dr. Duggal said.

Dr. Wyne’s essay also explained a virus connection to type 1 diabetes. It's been diagnosed after someone has an acute illness such as viral gastroenteritis or influenza. 

This prior illness causes the body's immune system to increase production of all antibodies, including the pre-existing ones, meaning the diabetes was already there.

Doctors say the COVID vaccines and boosters can certainly help, but based on data from those who have prediabetes, losing fifteen pounds can slow the progression of type 2, and of course improving your diet helps as well.

"We are seeing a lot of consequences in terms of long COVID and in terms of other factors. So absolutely, vaccinations, boosters and prevention remain the bedrocks for our fight against COVID," Dr. Duggal said.

If you think you may be at risk for diabetes and have had a COVID infection, there are symptoms to watch for, including:

  • Frequent urination, overnight or during the day
  • Increased thirst with blurry vision
  • Unexplained weight loss
  • Numbness in hands or feet
  • Slow wound healing

And fatigue, which of course is also associated with a COVID infection.

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