Existing evidence suggests that COVID-19 causes severe complications for patients with pre-existing diabetic conditions and can also be fatal. In addition to the latter, newer evidence is increasingly suggesting that coronavirus might also trigger diabetes in some.
"Diabetes itself is a pandemic just like the COVID-19 pandemic. The two pandemics could be clashing," Paul Zimmet studying metabolic disease at Monash University in Melbourne told Nature. Another scientist, Naveed Sattar of the University of Glasgow, also said that fatigue and muscle loss caused by severe COVID-19 infection can induce a pre-diabetic state in patients.
It was reported that experts suggested this could be a new form of diabetes, but the case of Finn Gnadt who is 18, from Germany's Kiel, was asymptomatically infected with COVID-19. He thought the infection went away unscathed, but a few days later he felt exceedingly thirsty and worn out. He was diagnosed with type-1 diabetes. His physician suggested that a sudden onset could be linked to the coronavirus infection.
Coronavirus Damages Sugar Controlling Cells
Experts had said that the exact mechanism by which novel coronavirus influences glucose metabolism was still not clear. But, a new study on miniature lab-grown pancreases suggests that the SARS-CoV-2 might trigger diabetes by damaging the cells that control blood sugar.
The study showed how SARS-CoV-2 could be damaging the pancreas. Shuibing Chen, a stem-cell biologist from Weill Cornell Medicine in New York City, and her colleagues showed that the new virus can infect α- and β-cells (alpha and beta cells), and some such cells die.
Similar to Type-1?
In case of type 1 diabetes, the body's immune cells start destroying β-cells, In Gnadt's case, his physician, Tim Hollstein at the University Hospital Schleswig suspected that coronavirus destroyed his β-cells, as his blood didn't have such immune cells that destroy β-cells.
Coronavirus can induce the production of chemokines and cytokines, the proteins that trigger an immune response that can kill α- and β-cells, according to the study published last week.
The COVID-19 causing virus also attacked pancreatic organoids transplanted to mice, and cells in liver organoids. One of the liver functions is in storing and releasing sugar to the blood-stream on sensing insulin.
This study strengthens the evidence that SARS-CoV-2 might cause or worsen diabetes, but experts say, more research is needed.
Shane Grey, an immunologist from Garvan Institute of Medical Research, Sydney says that coronavirus could also trigger an extreme inflammatory state, impairing the pancreas' ability to sense glucose and release insulin. This affects the liver's ability in detecting the hormone, triggering diabetes.