When Craig Spanza continued to suffer from headaches after receiving COVID-19 in March, he thought he might be experiencing some long-lasting COVID symptoms. The Vancouver resident expected to be told by his doctor how to cope with his constant headaches, but instead he was diagnosed as diabetic.
“It was just over two weeks after COVID-19 was officially over when I found out I was diabetic,” Spanza said.
As new variants of concern emerge, there is growing certainty among medical experts that the virus can also cause diabetes. Two studies supported by the National Institutes of Health (NIH) in the United States showed that COVID-19 caused severe damage to the beta cells in the pancreas, limiting how much insulin could be produced. If there is a lack of insulin, the blood sugar level will rise, resulting in diabetes.
“The virus can directly damage the cells that produce insulin, which is the key to controlling glucose, so less insulin, less glucose control,” said Dr. Remi Rabasa, an endocrinologist at the University of Montreal.
There are at least two other ways in which the virus can cause damage inside the human body which can lead to diabetes. If infected with COVID-19, the virus can replicate in the pancreas and into other cells surrounding the beta cells. The virus can also cause cells to malfunction so that they are no longer able to regulate blood properly.
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49-year-old Spanza admitted he had some markers of pre-diabetes, but said his battle with COVID-19 was awful. It resulted in him being hospitalized as he suffered from difficulty breathing, severe chest pain and loss of sensitivity in the extremities.
What Spanza described is a serious infection that Rabasa said “may limit the ability of insulin to work in tissues,” and is just one of “many ways COVID-19 can trigger diabetes.”
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A September 15 study published on cell.com showed that rising blood sugar levels were common among hospitalized COVID-19 patients. Patients needed longer hospital stays and were at higher risk of “developing acute respiratory distress syndrome and increased mortality.”
Researchers of the study concluded that hyperglycemia, an increase in blood sugar levels, was caused by COVID-19, which disrupted the fat cells’ production of adiponectin, a hormone that helps regulate blood sugar levels.
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Rabasa, who also works at the Center Hospitalier de l’Université de Montréal, said he has seen several patients dealing with severe cases of COVID-19 exhibit hyperglycemia. He noted that there is “evidence that short-term COVID leads to diabetes.”
He added that we could simply see elevated blood sugar for a short period of time, meaning that while some people may not develop diabetes right away, the effects on their beta cells and tissue damage may become persistent and make them more susceptible to getting diabetes. it later.
Research at Harvard Medical School showed that of 551 patients admitted to COVID-19 in Italy, nearly half became hyperglycemic. Patients were tracked for six months after the first infection, and the researchers found that hyperglycemia remained in about 35 percent of people.
Experts say the concern is not only that patients get diabetes from COVID, but that anyone who is already diabetic who gets COVID has a higher risk. A Scottish study found that people who already had type 1 or type 2 diabetes were already at greater risk of a poorer outcome if they received COVID-19.
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“The overall risk of fatal or intensive treatment with COVID-19 was significantly increased in those with type 1 and type 2 diabetes compared with the background population,” the study reads.
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While infection may be one of the concerns that result in diabetes, Rabasa said COVID-19 also has indirect effects on how someone can become diabetic. He mentioned that the “lack of exercise and sedentary lifestyle” that is a result of the pandemic where more people are confined to being at home could also contribute to it.
“If you’ve been less active, not eating as well as you should, COVID is causing you stress to eat your emotions, the things driving type 2 diabetes,” he said.
What does the data tell us?
It is 100 years since the discovery of insulin, a medical advance that has enabled people with diabetes to regulate their blood sugar levels at any time. Despite leaps in medicine and an understanding that exercise and good nutrition can help stave off diabetes, there has been a “tendency for more people to come forward with newly diagnosed diabetes,” according to Dr. Seema Nagpal, Vice President of Science and Politics at Diabetes Canada.
“It is a concern that we are already seeing very high incidences of diabetes and that this may be another contributing factor,” she said.
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A 2020 analysis from McMaster University showed that of patients with severe COVID-19, nearly 15 percent developed diabetes. The authors of the study noted that some people may have already been at risk for diabetes before getting the virus.
Nagpal noted that no data has been collected in Canada regarding the current frequency of diabetes since the pandemic began. As a result, she said Diabetes Canada could not confirm whether the potential increase in diabetes rates is directly caused by COVID-19.
A New York-based study looking at patients admitted to New York-Presbyterian Hospital / Weill Cornell Medical Center and affiliated campuses at Queens and Lower Manhattan Hospital found that 49.7 percent of the 3,864 patients diagnosed between 1 March 2020 and May 15, 2020, had hyperglycemia.
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While nearly half of the patients suffering from hyperglycemia are dizzy, the numbers rose to “91.1% and 72.8% among intubated and deceased patients,” researchers found. The hospital stay for people with hyperglycemia was 10 days compared to five days for those without.
The authors of a August 2021 study from Stanford University finally concluded that “SARS-CoV-2 can directly induce beta cell killing,” which would support the growing evidence that COVID-19 has a direct link to diabetes.
Without vaccines and masks being ways to limit COVID-19 infections and therefore potential cases of diabetes, there are ways to reduce the risk. Diabetes Canada notes that make lifestyle changes help reduce your chance of developing diabetes.
“Eating healthy, moving more and losing weight if you are overweight are the most effective things you can do to reduce your risk of developing type 2 diabetes,” they write on their website.
Spanza is grateful for early diagnosis on his path to recovery and says he has been able to incorporate better nutrition and exercise into his diet to keep his diabetes at bay. He said he keeps an eye on how much carbs, fat and sugar he eats and that he is generally much more aware of his diet choices.
Since implementing the changes, Spanza said the headache is not as frequent and he feels physically much better.
“It feels like it’s suddenly – from mid-October – it’s like it’s suddenly fallen off,” he said.
– with files from Jamie Maraucher and Leslie Whyte
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