Indeed, there is a bidirectional relationship between Covid-19 and diabetes and since my interests have always been in the field of MetS and type 2 diabetes mellitus (T2DM) I pose this question and discussion over the weekend and hope that a robust discussion with thoughts ideas and new concepts can be of interest to our readers.
My thoughts are that there may be many people with MetS that encompass many of the co-morbidities such as Obesity (visceral obesity driving a chronic inflammatory condition), hyperlipidemia, hyperinsulinemia hyperamylinemia with both insulin and leptin resistance, hypertension and impaired blood glucose and of older age prior to
developing COVID-19 infection. These are not only co-morbidities but also part and partial of the major components of the MetS in which insulin resistance plays a central role.
Acute hyperglycemia may be present during the acute phase of the disease even if these co-morbidities are not present due to inflammation (toxic cytokine storm) in the pancreatic islets and the fact that ACE2 is present on Beta cells of healthy individuals. Also, inflammation and oxidative stress form a vicious cycle, i.e. one begets the other.
So as the disease improves and the patients get better the high glucose levels may resolve along with infection and in most cases, these situations would be the younger people who develop the infection.
However, those with the MetS with multiple co-morbidities may develop an ACCELERATION of the natural progression of the Natural history of T2DM due to not only the ACE2 being present on the beta cells but also on the endothelial cells (ECs) of the capillary blood supply to the islet that is associated with increased inflammation and oxidative stress. This would implicate Redox stress storm, cytokine storm and virion storm ( or viral load).
An excellent discussion of this topic was recently on Medscape as follows in this link:
https://www.medscape.com/viewarticle/932282?src=WNL_recnl_200615_MSCPEDIT_endo&uac=369550CG&impID=2420747&faf=1
Also the publication regarding the registry
Rubino F, Amiel SA, Zimmet P, et al. New-Onset Diabetes in Covid-19. N Engl J Med. 2020 Jun 12. doi: 10.1056/NEJMc2018688. Online ahead of print. just use the doi to read more about this registry.
Here is the website for this registry:
covidiab.e-dendrite.com
This question and discussion are now open to all who are interested in this topic and I am looking forward to any and all suggestions as to your thoughts concepts or ideas regarding this topic of interest. All of your interests will be appreciated.
Melvin R. Hayden, MD
nickname "pete" after my grandfather
e-mail [email protected] if you would prefer to discuss on e-mail
I Hope all are well and staying safe during these international trying times. We are all one people! Makes me think of the song IMAGINE by john lennon - IMAGINE all of the people as one facing this SARS -CoV-2 viral pandemic so ... let the world be as ONE!
pete
dear Ijaz Durrani
I am very thankful for your answer
wefak labazi.
Very helpful and thank you for your excellent and referenced input
pete hayden
Effect of COVID-19 on diabetes
COVID-19 may be the cause of different types of diabetes either because of the direct effect of the SARS-CoV-2 (1-3) or the side-effects of COVID-19 (4) or by the sedentary lifestyle caused by the compulsory lock-downs to prevent the spread of the pandemic.
:Therefore, there is likely to increase in Type 1, type 2, as well as secondary diabetes as a result of COVID-19 pandemic.
The following articles highlight these aspects:
1. Conference Paper Viral Infection in the Pathogenesis of Type 1 Diabetes
2. Article COVID-19 presenting as acute pancreatitis
3. Article Association of the insulin resistance marker TyG index with ...
4. Article Coronavirus and Obesity: Could Insulin Resistance Mediate th...
5. Article Dexamethasone-induced insulin resistance and pancreatic adap...
6. Article Health risks and potential remedies during prolonged lockdow...
Dear Muhammad Yousuf,
Thank you very much for sending me these references as they have been very helpful to increase my understanding of T2DM and COVID-19. I agree with your observation that both direct and indirect effects regarding the binding of SARS-CoV-2 virus to ACE2 and the resultant Redox storm, Cytokine storm and Viral load or Viral Virion Storm are extremely important!
I hope that you and yours are doing well in these times of uncertainity. I appreciate you time and effort in responding to this Question as I am certain it will also help others in our time of unity!
M.R. Pete Hayden
University of Missouri School of Medicine
Columbia, Missouri USA
Please see new publication in Journal Cells MDPI:
An Immediate and Long-Term Complication of COVID-19 May Be Type 2 Diabetes Mellitus:
here is the doi:
https://doi.org/10.3390/cells9112475
Melvin R Hayden
University of Missouri School of Medicine
Columbia, Missouri USA
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