Managing a chronic condition requires an unparalleled attention to detail and commitment to longevity. This is especially true when living with diabetes. Individuals who have been diagnosed with different types of diabetes need to meticulously plan, track, and record several parts of their daily life to ensure that essential systems are functioning properly. Unfortunately, with the onset of COVID-19, a troubling connection has been identified. In addition to the potentially serious side effects caused by the SARS-CoV-2 virus, new research has shown a link between acute infections and the onset of type 1 diabetes. For more information regarding this connection, here we’ll aim to answer an increasingly pressing question: can COVID-19 cause type 1 diabetes?
What is Type 1 Diabetes?
There are different types of diabetes that an individual can be diagnosed with. Type 1 diabetes is less common than type 2, but it can cause more severe complications due to the timing of diagnosis. Type 1 diabetes occurs when your pancreas doesn’t make enough insulin, or any at all. It’s a chronic condition that requires ongoing treatment and management to ensure that your body is able to regulate blood sugar levels and avoid serious instances like diabetic ketoacidosis or hyperglycemia. Type 1 diabetes is often diagnosed in childhood, but adults can still develop type 1 diabetes during their life. The earlier an individual is diagnosed with type 1 diabetes, the more at-risk they are for complications as they age.
While the cause of type 1 diabetes remains unclear, it’s often related to genetic or environmental triggers. During the onset of the condition, your body’s immune system begins to attack healthy, insulin-producing beta cells, which severely hinders your pancreas’ ability to contribute to a healthy blood glucose level. Taking the time to understand your genetic predisposition to type 1 diabetes is more important than ever, as there has recently been information that suggests a connection between type 1 diabetes and COVID-19.
The Link Between COVID-19 and Type 1 Diabetes
Several NIH-supported studies provide evidence that the SARS-CoV-2 virus may, in fact, target and destroy cells within the pancreas that are responsible for making insulin. The difficulty is in determining whether COVID-19 is the underlying cause of the onset of type 1 diabetes or if it was simply an infection that brought type 1 diabetes into awareness sooner than it would have been identified on its own. There are millions of people who remain undiagnosed for diabetes and prediabetes, which can cause a skew in data regarding correlation vs. causation. However, recent studies do show that COVID-19 survivors were about 39% more likely to receive a new diabetes diagnosis in the six months after infection compared to non-infected individuals. Therefore, it’s important to explore the link between COVID-19 and type 1 diabetes.
Evidence from one study found that the SARS-CoV-2 virus infects human beta cells, which are the cells in the pancreas that secrete insulin. Beta cells, along with other pancreatic cells, have specific proteins that COVID-19 relies on to spread infection throughout the body. Once the virus attaches themselves to these cells and infects them, it’s been shown that cellular function is altered, and the beta cells reduce the amount of insulin that’s produced and released into the bloodstream. This process is called transdifferentiation and causes the cell to essentially transform into something entirely different. Beta cells become cells that no longer manufacture insulin. In other instances, the SARS-CoV-2 virus causes the death of the beta cells altogether—a process called cellular apoptosis. Both of these circumstances lead to the same thing—a decrease in the body’s ability to produce insulin. When the body is no longer able to produce its own insulin, type 1 diabetes can occur.
This type of trigger is not uncommon in patients diagnosed with type 1 diabetes. Individuals are born with genetic risk factors that can induce autoimmune reactions to certain infections, especially illnesses like influenza or viral gastroenteritis. However, type 1 diabetes sometimes requires an environmental trigger for the autoimmune reaction to begin. Now, evidence is showing that COVID-19 is another trigger that may initiate the autoimmune reaction present in individuals diagnosed with type 1 diabetes.
Is There a Link Between COVID-19 and Type 2 Diabetes?
Unlike type 1 diabetes, which is an autoimmune disease, type 2 diabetes is brought on by unhealthy lifestyle habits in conjunction with genetic predisposition. Those who develop type 2 diabetes tend to already have an impaired relationship between insulin production and insulin resistance, which is then exacerbated by stressors such as diet, weight, and physical activity levels. However, there are also other stressors that can disrupt the balance and lead to the onset of diabetes. One of these stressors is the inflammation from cytokine activation that is commonly seen in those suffering from COVID-19. While commonly referred to as “stress hyperglycemia,” there are some instances where glucose levels don’t return to normal, and the individual is later diagnosed with diabetes.
One major difference in regard to the link between COVID-19 and type 2 diabetes is that many individuals who develop the chronic condition following an infection with the SARS-CoV-2 virus likely already had undiagnosed prediabetes. It’s also important to look at the fact that many genetic and lifestyle factors that increase your risk for developing type 2 diabetes are similar to those that increase your risk for severe COVID-19. Severe infections of COVID-19 require high-dose steroids for treatment, which can affect your glucose levels. In an attempt to return to homeostasis, your pancreas will need to increase insulin output and when it can’t keep up, prediabetes and type 2 diabetes can develop.
Reducing Your Risk of COVID-19 Induced Diabetes
While more research is required to better understand the link between COVID-19 and diabetes, it’s important for anyone who tests positive to keep an eye out for symptoms both during infection and following recovery. Those who notice any symptoms of type 1 diabetes or type 2 diabetes should see their doctor for testing. Some of the most common symptoms of type 1 diabetes include the following:
- Increased urination
- Feeling dehydrated
- Increased appetite
- Blurred vision
- Weight loss
- Numbness or tingling in hands or feet
- Extremely dry skin
- Nausea and vomiting
- Slow healing sores
- Diabetic ketoacidosis
Contact your doctor if you notice any of these symptoms, especially if you’ve been diagnosed with COVID-19. It’s also essential that you talk to your doctor about what to do if you test positive for COVID-19 early on, especially if you know you have risk factors for diabetes. There have been a few possible therapies that are being tested to help beta cells maintain their identity and avoid the transidfferentiation process. One of these therapies is Trans-ISRIB, or Trans-Integrated Stress Response InhiBitor. This can help reduce the stress of response cells and therefore, the risk of developing diabetes. Medications that block Neuropilin 1 (NRP 1) may also help prevent beta cell apoptosis. Always talk to your doctor about treatment options and avoid self-diagnosis. More research is needed to fully understand how the SARS-CoV-2 virus impacts the body and how to inhibit these changes.
If you begin to show any symptoms of COVID-19, contact your doctor immediately. The SARS-CoV-2 virus has a direct impact on how your body processes insulin, so it’s important to seek treatment early and do what you can to avoid ongoing problems. One of the best ways to reduce your risk of suffering from a serious case of COVID-19 is to get vaccinated. If you haven’t already, talk to your doctor about scheduling your first dose today.
While being diagnosed with diabetes will bring substantial changes to your life, it doesn’t mean that you can’t still do the things you love. With the proper diabetes management, you can live a full, happy, and healthy life. To help you along the way, Byram Healthcare has a range of continuous blood glucose monitors. We also offer diabetes support and educational materials to give you everything you need for comprehensive care. For more information and added support on diabetes management, sign up for Byram Healthcare’s Caring Touch At Home™ Program.
