For months, it’s been known that people with diabetes are at a higher risk of poor outcomes related to COVID-19 if they develop the viral infection — including hospitalization, admission to an intensive care unit (ICU) and death. While there isn’t any single factor that explains this link, one possible explanation is that having elevated blood glucose causes inflammation that diminishes your body’s immune response to the virus — a theory that is supported by some evidence.
But now, it appears that the relationship between diabetes and COVID-19 doesn’t just run in one direction. A new study, along with anecdotal reports from some hospitals, suggests that people who get COVID-19 may be at higher risk for developing diabetes.
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Unexpected new diabetes cases
A recent article in The Washington Post looked at reports from some doctors and hospitals that new diabetes diagnoses seem to be unusually common in people who have had COVID-19. One doctor who heads a diabetes care team in a hospital in Bethesda, Maryland, noticed that as the caseload of COVID-19 patients at the hospital increased so did his own caseload. While the team previously cared for about 18 hospital patients each day, that number got closer to 30 — and many of these new patients had no previous history of diabetes.
While some patients had elevated blood glucose while they were in the hospital but returned to normal levels once they recovered from COVID-19, others continued to have diabetes even after their recovery. Right now there isn’t any clear explanation for why this happened — and continues to happen. It may be that people who develop diabetes were already on the “path” to a diagnosis, and that their COVID-19 infection somehow speeds up this process. Many people hospitalized for COVID-19 already have diabetes risk factors, like obesity or a family history of diabetes.
Another potential factor is the use of dexamethasone, a steroid drug that is one of the most common treatments used to treat people hospitalized with COVID-19. While this drug has been shown to help prevent poor outcomes related to COVID-19, one potential side effect seen in many people is elevated blood glucose. It’s possible that in some people, this drug-induced high blood glucose leads to a cascade of changes that keep blood glucose levels high even once they no longer take the drug.
Analysis shows high rate of new diabetes
These anecdotal findings are supported by an analysis published in November 2020 in the journal Diabetes, Obesity and Metabolism, which looked at eight studies involving newly diagnosed diabetes in people hospitalized with COVID-19. The included studies were conducted in China, Italy and the United States between January and May 2020, and found that among over 3,700 people hospitalized with COVID-19 who weren’t previously known to have diabetes, 14.4% received a diabetes diagnosis during the study period — either during or shortly after their hospital stay.
“COVID‐19 patients with newly diagnosed diabetes should be managed early and appropriately and closely monitored for the emergence of full‐blown diabetes and other cardiometabolic disorders in the long term,” researchers wrote in that article. “We are now seeing a classic example of a lethal intersection between a communicable and a non‐communicable disease.”
The researchers also noted that based on recent reports, people who develop signs of diabetes while hospitalized for COVID-19 may be at higher risk for poor outcomes than those with a previous diabetes diagnosis — making detecting new cases of diabetes in COVID-19 patients that much more important.
More studies — and larger studies — are needed, the researchers wrote, to look at the connection between COVID-19 and new diabetes cases in people who aren’t hospitalized for the infection, as well as in more countries and geographic regions.
Want to learn more about coronavirus and diabetes? Read our latest COVID-19 updates.