British experts have called for an international effort to examine the link between COVID-19 and new-onset diabetes.
Writing in Diabetes Care, they say early identification and treatment of people who develop diabetes following COVID-19 infection could improve their long-term outcomes.
The comments follow a comprehensive review led by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East Midlands, which involved an international team of researchers.
Professor Kamlesh Khunti, director of NIHR ARC East Midlands and Professor of Primary Care Diabetes and Vascular Medicine at the University of Leicester, said: “Given we are still in the midst of a global COVID-19 pandemic, we are likely to see even larger numbers of people globally with new-onset diabetes. International efforts need to be established to study COVID-19 associated new-onset diabetes with follow-up of large numbers of patients.”
Several studies have reported an association between COVID-19 and hyperglycaemia in people with and without known diabetes, while the authors of this research also acknowledge the phenomenon of new-onset diabetes following admission to hospital has been seen with other viral infections.
They examined four possible explanations: that some patients may have had undiagnosed diabetes; that they had stress hyperglycaemia and new-onset diabetes following acute illness – in COVID-19 stress hyperglycaemia may be even more severe due to the cytokine storm; viral infections may have an effect on the pancreas and could lead to new-onset diabetes; and perhaps in-hospital steroid-induced hyperglycaemia.
Professor Khunti said: “There is an urgent need for research to help guide management pathways for these patients. In view of increased mortality in people with new-onset diabetes, hospital protocols should include efforts to recognise and manage acute hyperglycaemia, including diabetic ketoacidosis, in people admitted to hospital.”
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