Laura Hegwer: Understanding the link between COVID-19 and diabetes

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The National Institute of Diabetes, Digestive and Kidney Diseases recognizes more than 50 different ways that a person can develop diabetes, from defects in a single gene to other health issues like liver disease.

April 29, 2022

Understanding the link between COVID-19 and diabetes

by Laura Hegwer, Rush University Medical Center

Amid the many problems posed by the pandemic, one positive outcome is that COVID-19 is providing valuable insights that could help researchers unlock the secrets of another intractable disease: diabetes.

At RUSH, researchers are using data gathered during the pandemic to understand the connection between the two diseases and why COVID-19 affects people with diabetes differently.

People with diabetes face higher COVID-19 risks

Over the past two years, data has shown that people with type 2 diabetes are more likely to develop severe COVID-19 that leads to hospitalization and sometimes death—and the reason is likely inflammation, says Rasa Kazlauskaite, MD, MS, director of the Diabetes Technology Program at Rush University Medical Center and a RUSH endocrinologist.

“People with type 2 diabetes typically have chronic, low-level inflammation that is difficult to detect in clinical practice,” she says. “When they become infected with SARS-CoV-2, the virus that causes COVID-19, this low-level inflammation can become hyperinflammation that affects their lungs, heart and other parts of the body.” This hyperinflammation is what likely leads to more severe complications from COVID-19, she says.

Having diabetes may also put people at risk for “long COVID,” or what doctors call post-acute sequelae of SARS CoV-2 infection, or PASC, says Alan Landay, Ph.D., vice chair of research and division chief of translational and precision medicine in the Department of Internal Medicine at RUSH.

“In patients with diabetes, there’s a disordered metabolic environment that actually enhances the replication of the virus,” Landay says. “That may create a higher susceptibility to the virus, and it may also affect the clinical outcomes in those patients. But it’s not one-size-fits-all.”

To find out why only some people with diabetes develop COVID-19 complications, scientists at RUSH and the nonprofit research institute RTI International have been monitoring COVID-19 in patients with diabetes in Chicago as well as in Malaysia for comparison. So far, scientists have tracked differences in outcomes by age, sex, race/ethnicity, body mass index and other factors in 5,712 patients, with results to be published later this year.
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The National Institute of Diabetes, Digestive and Kidney Diseases recognizes more than 50 different ways that a person can develop diabetes, from defects in a single gene to other health issues like liver disease.

“Ideally, we would like to investigate each and every one of those 50 causes,” Kazlauskaite says. “And we are finding that some people have several diabetes causes at the same time. In other words, a patient may not just have the purely insulin-resistant type of diabetes, what’s typically defined as type 2, but they might also be affected by steroids or autoimmune diabetes at the same time.” Doctors may call this “hybrid diabetes,” suggesting that the etiology, or cause, of diabetes may be much more complex than originally believed.

For more:

https://medicalxpress.com/news/2022-04-link-covid-diabetes.html

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