COVID-19 can Trigger Type-1 Diabetes

COVID-19 infection triggers type-1 diabetes in people. This happens when the body’s immune system attacks the beta cells in the pancreas. These cells are responsible for the production of insulin in the body. It converts sugar in the blood to glucose. When beta cells get destroyed, there is impaired production of insulin. As a result blood sugar control is compromised causing type-1 diabetes.

Pancreas have both alpha and beta cells. Beta cells produce insulin which, reduces blood sugar levels, while alpha cells produce glucagon that increases blood sugar levels. In order to maintain a healthy blood sugar level, a fine balance between the two has to achieved.

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‘The bidirectional relationship between diabetes and COVID-19 can be used to understand whether COVID-19 can induce type-1 diabetes or if the acute-onset diabetes is permanent or temporary and whether people who are borderline type-2 develop the disease.’
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During the SARS 2002 outbreak, researchers in China had found increased evidence of developing diabetes in affected patients.

The study published in The New England Journal of Medicine states, “There is a bidirectional relationship between COVID-19 and diabetes. On the one hand, diabetes is associated with an increased risk of severe COVID-19. On the other hand, new-onset diabetes and severe metabolic complications of preexisting diabetes… have been observed in patients with COVID-19.”

Testing in Mice

Coronavirus
Coronaviruses infect animals, humans, and birds. Human coronaviruses, such as SARS, MERS, and 2019-nCoV cause respiratory distress and even death. The S protein is the infectious agent of the virus.

Researchers grew miniature pancreas and liver using human pluripotent stem cells and transplanted them to mice. After a couple of months, they found ACE2 receptors on both alpha and beta pancreatic cells. When the mice were infected with SARS-Cov-2 virus, the beta cells were infected which indicates that the virus is capable of damaging the cells that control blood sugar thus triggering the onset of acute type-1 diabetes.

Possible Mechanism

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Researchers found that SARS-Cov-2 virus binds to the angiotensin-converting enzyme 2 (ACE2) receptors in all the key metabolic organs like pancreatic beta cells, small intestine and kidneys, in the body. This may alter the glucose metabolism either complicating the pathophysiology of the preexisting diabetes or causing new ones.

When COVID-19 patients develop diabetes, there are high levels of sugar and ketones in their body. The insufficient insulin compromises the break down of blood sugar, leading to high levels of sugar. When sugar does not get converted to glucose, the body does not get adequate energy which, then turns to alternate sources like ketones. This leads to ketosis which increases morbidity and mortality in COVID-19 patients.

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Further research is needed to conclusively prove the relation between COVID-19 and type-1 diabetes and whether the acute-onset diabetes in such patients is transient or permanent.

Source-Medindia