COVID-19 and Diabetes: The Plot Thickens

The relationship between diabetes and COVID-19 grows more interesting by the day. Early in the pandemic, it became clear that diabetes is an important risk factor for severe complications with COVID-19. As more research emerged, it became clear that inflammation is a mediator for this risk. And now it seems that diabetes might even raise the risk for long COVID.

But another observation is also attracting attention now. New diagnoses of diabetes seemed to be going up as the pandemic unfolded. Could it be that COVID raises the risk for diabetes?

MMWR: Diabetes Up in Children

A new study from CDC appeared in MMWR earlier this month. In their study, Catherine Barrett and colleagues found evidence that children who recovered from COVID-19 were more likely to develop diabetes. They found this relationship in two separate cohorts of patient records from different databases. In one cohort, they found more than double the risk of diabetes after COVID. In the other, they found a 31 percent increase in risk.

Of course, these findings raise more questions than they answer. The study had limitations. It did not factor in obesity, race, ethnicity, and other potentially confounding variables. The definition of a diabetes diagnosis was not especially specific. The population in this study was not fully representative of the general population. So to be sure, further research on this issue will be necessary.

In fact, other research is pointing to COVID as an instigator of inflammation in fat cells that might in turn contribute to diabetes risk. So it could be that COVID can bring diabetes risk, just as diabetes can raise the risk for severe COVID symptoms.

Long COVID?

As if this were not enough, a new study in Cell suggests that pre-existing type-2 diabetes is one of four risk factors for developing long COVID. These are exploratory findings and will require further confirmation. Still, professor Steven Deeks of UCSF says:

“It’s the first real solid attempt to come up with some biologic mechanisms for long Covid.

“They’ve identified these four major factors. Each is biologically plausible, consistent with theories that other people are pursuing, and importantly, each is actionable. If these pathways get confirmed, we as clinicians can actually design interventions to make people better. That is the take-home message.”

At this point, it’s clear enough that the risks of COVID and diabetes are intertwined in multiple ways. Inflammation is playing a key role. With more and better science on this relationship, people can look forward to better outcomes.

Click here for the study of COVID and diabetes diagnoses in MMWR, here and here for further perspective. For the new study in Cell and further reporting on it, click here and here.

Never Think Before You Act, woodcut from Flor de Pascua by M.C. Escher / WikiArt

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January 26, 2022