Now, doctors observe diabetes in patients recovering from Covid-19

There is not enough scientific data to support a causal link, some doctors say

Can Covid-19 make a recovered patient diabetic? Over the last two months, a doctor in Hebbal has dealt with six non-diabetic people who turned diabetic after recovering from Covid-19. Three of them have recovered with normal diet.

Consultant endocrinologist at Aster CMI Dr Mahesh D M said the patients were left with diabetes due to a bidirectional relationship between Covid-19 and diabetes.

While diabetes is associated with the severe risk of Covid-19, new onset of diabetes and metabolic complications of pre-existing diabetes, including diabetic ketoacidosis (where the body produces high levels of blood acids called ketones) and hyperosmolarity (blood more concentrated than usual, drawing water from the body), have been observed in Covid-19 patients.

Read | Two pandemics clash as doctors find that Covid spurs diabetes

“We see patients with prediabetes develop into diabetes and some get new-onset diabetes,” Dr Mahesh said, explaining that coronavirus binds to certain receptors in the pancreas, alternating insulin release and affecting glucose metabolism, leading to the onset of diabetes. “Inflammation from Covid-19 also results in insulin resistance among patients."

Use of steroids

Doctors also say steroid use during the treatment of such patients can spike in the blood sugar level and contribute to insulin resistance, whereas rational steroid use with insulin can reduce inflammation from Covid-19 and complications resulting from high sugar.

"We now know that the Covid virus doesn’t just involve the lungs, it has a multi-system involvement,” Columbia Asia Hospital’s consultant endocrinologist Dr Abhijit Bhograj said in concurrence.

“There is increased immune and inflammatory responses affecting the organs directly such as the lung, heart, kidney and brain. In the case of diabetes, the pancreas gets affected and predisposes patients with chronic conditions, Covid-19 and possible adverse outcomes,” Dr Bhograj added.

The inflammation also causes disruption in the normal pathway and glucose homeostasis. Controlling blood sugar and blood pressure is the only way to fight the condition, besides getting vaccinated, he said.

'Follow medical advice'

Consultant of diabetes and endocrinology at Fortis Hospitals, Bannerghatta Road, Dr Srinivas Munigoti cautioned that the coronavirus’ role in damaging endocrine beta cells and spiking blood sugar is yet to be proven conclusively. “There is not enough scientific data to support a causal link,” he pointed out.

With or without Covid-19, patients should follow medical advice carefully and aim for good diabetic control, Dr Munigoti said.

Several complex factors are likely causing elevated sugar levels in Covid patients. If they do not follow medical advice, they may not control pre-existing diabetic conditions and may have to deal with high sugar.

While inflammation due to the infection increases insulin resistance and causes high sugar, using medications like steroids will add to the complications, Dr Munigoti added.