COVID-19 alters patient metabolism, may induce diabetes

INDIANAPOLIS (WISH) — Scientists say diabetics are more vulnerable to COVID-19, while at the same time, people infected with the virus could be at greater risk of developing diabetes. 

In a recent article published in the New England Journal of Medicine, health experts suggest a bidirectional relationship exists between the novel coronavirus and diabetes.

The virus binds to critical organs involved in digestion and elimination of waste products, including the pancreas, liver and kidneys, said lead author Dr. Francesco Rubino in the paper “New-Onset Diabetes in COVID-19.”

These organs — collectively involved in metabolism — all have what are called angiotensin-converting enzyme 2 receptors (ACE2) on the outside of the organs’ tissues. 

The coronavirus is known to attack ACE2 cells, resulting in weakened receptor functions. Two virus complications have been identified in patients: diabetic ketoacidosis and diabetic hyperosmolarity.

Diabetic ketoacidosis occurs when there are dangerously high levels of sugar, known as glucose, in the blood without sufficient insulin. Insulin is needed to help the glucose travel to the organs and tissues. To make up for the lack of insulin, the liver secretes acidic chemicals called ketones. In high amounts, circulating ketones can lead to nausea, vomiting, fainting and death. 

Diabetic hyperosmolarity is also characterized by high levels of blood glucose coupled with insufficient insulin and is often triggered by an infection or illness. In an effort to get rid of the excessive glucose, the body tries to eliminate it through the urine, which is harmful to the kidneys. 

Scientists are seeing an increase in the number of diabetic ketoacidosis and hyperosmolarity in COVID-19 patients and argue it’s possible a novel coronavirus infection alters a persons’ metabolism, resulting in virus-induced diabetes even in people without a prior history of the illness.