Stress caused by the COVID-19 infection could cause a temporary form of diabetes and may explain high rates of new diagnoses of the condition during the pandemic, a study has suggested.

Researchers from Massachusetts General Hospital found that many people admitted with COVID-19 and diagnosed with diabetes may see their blood sugar levels return to normal after being discharged from hospital.

The team also suggests that for a number of these patients – who tend to be non-white and uninsured – their condition may not necessarily be new, but rather pre-existing and undiagnosed due to their limited access to healthcare services.

The reason why there have been high rates of newly-diagnosed diabetes around the world during the pandemic has been unclear, with academics looking at whether these are truly new or undiagnosed cases; why blood sugar levels are elevated; and whether these levels return to normal after COVID-19.

Lead author Dr Sara Cromer, an investigator with the Department of Medicine -Endocrinology, Diabetes and Metabolism at the hospital, said: “We believe that the inflammatory stress caused by COVID-19 may be a leading contributor to ‘new-onset’ or newly diagnosed diabetes.

“Instead of directly causing diabetes, COVID-19 may push patients with pre-existing but undiagnosed diabetes to see a physician for the first time, where their blood sugar disorder can be clinically diagnosed. Our study showed these individuals had higher inflammatory markers and more frequently required admission to hospital ICUs than COVID-19 patients with pre-existing diabetes.”

The researchers looked at the data of almost 600 people who displayed symptoms of diabetes on admission to the hospital in spring 2020. Key findings included:

  • Of the 594 individuals, 78 had no previous diagnosis of diabetes
  • Newly diagnosed patients had less severe blood sugar levels compared to those with pre-existing diabetes, but worse symptoms of COVID-19
  • Of this group, about half saw their blood sugar levels return to normal, and only 8% needed insulin after a year.

Dr Cromer said: “This suggests to us that newly diagnosed diabetes may be a transitory condition related to the acute stress of COVID-19 infection.

“Our results suggest that acute insulin resistance is the major mechanism underlying newly diagnosed diabetes in most patients with COVID-19, and that insulin deficiency, if it occurs at all, is generally not permanent. These patients may only need insulin or other medications for a short time, and it’s therefore critical that physicians closely follow them to see if and when their conditions improve.”

The study has been published in the Journal of Diabetes and its Complications.

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