This story is from September 19, 2020

In Chennai, Covid-19 infection sparks fear of diabetes

Covid-19 infection, which has affected more than five lakh people in the state, is triggering diabetes in healthy people. In many diabetics, the condition has worsened with dangerously high sugar levels or patients developing complications including organ disorders.
In Chennai, Covid-19 infection sparks fear of diabetes
Image used for representational purpsoe only
CHENNAI: Covid-19 infection, which has affected more than five lakh people in the state, is triggering diabetes in healthy people. In many diabetics, the condition has worsened with dangerously high sugar levels or patients developing complications including organ disorders.
Post-Covid-19 clinics that have screened more than 250 people over the past two weeks have found at least four healthy people developing diabetes.
In at least 10 others, who had diabetes, their condition has worsened, said Dr R Umamaheshwari of the department of community medicine. Doctors from several private hospitals are now reporting onset of diabetes as one of the major post-Covid complications.
While diabetes is associated with increased morbidity risk among Covid-19 patients, onset of diabetes and metabolic complications, including organ failures, in pre-existing diabetics have been observed in people with Covid-19, say infectious diseases experts.
Many diabetics are pumped in with high doses of insulin due to conditions such as ketoacidosis (build up of acidic substances called ketones at dangerous levels) and hyperosmolarity (high concentration salt (sodium), glucose, and other substances in blood). “Diabetes has been the commonest cause for death in Covid-19 patients, but we now think there could be a stronger relationship between the metabolic disorder and the novel virus,” Dr Umamaheswari said.
Scientists say ACE-2, the protein that binds SARS-Cov-2 (the virus that causes Covid-19) allowing it to enter human cells, is located in organs and tissues involved in glucose metabolism such as the pancreas, the small intestine, the fat tissue, the liver and the kidneys, besides lungs. While doctors initially asked people to stop antihypertension medications that pushed up ACE inhibitors, the recommendation was withdrawn as doctors felt risks may outweigh benefits.

The most cited reasons for variations in glucose levels are high doses of steroids during their active phase of the viral infection. Steroids work well in bringing down symptoms in several patients. It mimics the action of cortisol, a hormone produced in the body, which increases insulin resistance and hence the blood glucose levels. “They block the action of insulin. The blood glucose levels go up so high that the first drug of choice for these patients are insulin shots. After a few weeks, we taper down insulin and put them on tablets. As of now we don’t know if their condition can be reversed,” he said.
Work is in progress to find if the virus may cause multiple and complex dysfunctions of glucose metabolism or directly attack beta-cells causing insulin deficiency. “We are yet to see that kind of diabetes (type1) here in India,” said senior diabetologist Dr V Mohan, who has seen a few patients developing type 2 diabetes days after they were infected with Covid.
Infectious diseases expert Dr Subramanian Swaminathan says as of now there is no evidence as to why the virus influences metabolism or whether manifestation of diabetes in these patients is type 1, type 2 or possibly a new form of diabetes. “A global registry and detailed study will probably give us more data,” he said.
End of Article
FOLLOW US ON SOCIAL MEDIA