This is the analysis of health records from 1,171 general practices in Germany. The analysis reveals that adults who recover from mostly mild COVID-19 appear to have a significantly higher risk of developing type 2 diabetes. This level of risk is compared to that of a matched control group with other types of respiratory infections but free of COVID.
Should diabetes be screened following a COVID diagnosis?
The study: this is the analysis of the health records of 8.8 million adults who consulted in 1,171 general medicine practices in Germany between March 2020 and January 2021, including those of 35,865 patients diagnosed with COVID -19. The incidence of diabetes in these patients diagnosed with COVID-19 was compared to that of a cohort of controls diagnosed with an acute upper respiratory tract infection but not COVID-19, over the same study period. Controls were matched for a large number of factors, including gender, age, health insurance coverage, comorbidities (obesity, high blood pressure, high cholesterol, heart attack, stroke). The analysis finds that:
- new cases of type 2 diabetes are more frequent in patients who test positive for COVID-19 than in controls, i.e. 15.8 vs 12.3 per 1,000 people per year;
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this represents a 28% increased risk.
If these conclusions were confirmed, this would mean, in effect, the interest of screening patients for diabetes, following recovery from mild forms of COVID-19. This possible link between COVID-19 and diabetes is also being studied in other ongoing research, including the symptoms of long COVID. Finally, previous studies have noted that the inflammation caused by SARS-CoV-2 can damage insulin-producing beta cells, leading to acute hyperglycemia (high blood sugar). Tissues might also become less responsive to insulin due to inflammation in the body. Finally, the more sedentary lifestyle imposed by the pandemic may also have played a role. Because, overall, recent-onset hyperglycemia and insulin resistance have been frequently reported in patients with COVID-19 who do not have a history of diabetes.
The authors write: “COVID-19 infection can lead to diabetes through upregulation of the immune system following recovery, which can induce pancreatic beta cell dysfunction and insulin resistance. Patients may have been at risk of developing diabetes due to obesity or prediabetes, and the stress of COVID -19 will have exacerbated this risk. Indeed, the risk of abnormally high blood sugar in people with COVID-19 is most likely a continuum, linked to risk factors such as beta-cell damage, exaggerated inflammatory response, and changes in related weight gain. to the pandemic and the decrease in physical activity”.
The higher risk of diabetes following a COVID-19 infection therefore appears to be real and multifactorial. However, while COVID-19 patients are only followed for a few days or weeks, additional follow-up is needed to identify type 2 diabetes following mild COVID-19 and verify that it is only temporary and may be reversed following full recovery.
Although type 2 diabetes is unlikely to be a problem for the vast majority of people with mild COVID-19, the authors recommend that anyone who has recovered from COVID-19 be aware of the warning signs. and symptoms such as fatigue, frequent urination, and increased thirst.
