Study looking at causes of new cases of diabetes developing in people after having Covid-19

An international group of diabetes researchers and clinicians have established a global database of new cases of diabetes in patients with Covid-19

Following observations that Covid-19 could potentially trigger diabetes researchers at King's College London and Monash University in Australia realised there was an urgent need for more information.

Researchers set up the CoviDiab Registry Project to collect data on people newly-diagnosed with diabetes and with confirmed Covid-19.

They plan to collect data on people with existing diabetes who present with Covid-19 with the aim of investigating the link between the two conditions.

Ultimately, researchers hope to understand whether Covid-19 causes a new form of diabetes or is more simply a stress response that triggers classic type 1 or type 2 diabetes.

The CoviDiab team are calling for healthcare professionals to contribute patient data to the registry.

Researchers said it is still unclear if the alterations of glucose metabolism that acutely occur with severe Covid-19 will persist after recovering from the virus.

They intend to look at whether if diabetes stops, do patients remain at higher risk of future diabetes or DKA? Does this phenomenon represent abrupt onset of classical type 1 and type 2 diabetes or a new type of diabetes? Answering these questions is a priority of vital importance to inform the immediate clinical management, follow-up and monitoring of those affected.

Researchers at Monash University revealed that a recently published study showed a pooled proportion of 14.4% (1 in 7) for newly diagnosed diabetes in studies on a total of 3,711 hospitalised Covid-19 patients.

Many patients had no known instances of diabetes in their family and were not believed to have been at high risk for the illness prior to being infected with the coronavirus. Professor Paul Zimmet of Monash Medicine’s Department of Diabetes said that he had been contacted by numerous individuals and families, who reported suspicious cases of diabetes after falling ill and suspected a causal connection.

Professor Zimmet said: “From studies of ICU mortality rates, up to 40% of the deaths were people who either had diabetes or had developed it at the time they were admitted.

“This was a very strange situation, so I decided we should set up a register to record new cases of diabetes coming from people with Covid-19.”

According to Professor Zimmet, the underlying concern is whether Covid-19 is causing diabetes in patients, or whether a pre-existing and undiagnosed case of diabetes in some people is increasing their vulnerability to coronavirus.

Professor Zimmet said: “When we realised we had a pandemic on our hands here in Australia, I was concerned what this meant for people with diabetes.

“The question is whether, in fact, Covid-19 was causing diabetes, or diabetes was making people more likely to contract infections.”

Professor Zimmet said it was not uncommon for people to have diabetes without knowing it, and that chronic illnesses such as Covid-19 can precipitate or worsen the disease. There is also the possibility that diabetes decreases the chance of having Covid-19 with no symptoms.

Researchers are investigating what may be causing people to develop type 1 and type 2 diabetes after being diagnosed with Covid-19

The Monash University-Kings College London medical register has already recorded more than 50 cases from different parts of the world, providing a multi-ethnic sample group that makes clear the correlation is indeed a global phenomenon, requiring global attention.

The register is the first of its kind, and at this early stage, the interaction between Covid-19 and diabetes is still poorly understood.

Professor Zimmet said: “We’re hopeful we can contribute to a better understanding of whether Covid-19 can cause diabetes and get some leads as to what the mechanisms are, as well as what treatment may be appropriate.”

Beyond the initial diagnosis of diabetes, the team will continue to monitor patients on the register to see if further complications and health complications arise as a result of the Covid-19 infection.

Professor Zimmet noted that the emergence of diabetes after infection of the virus was not limited to adults but was also being observed in children, providing another reason to suspect that even benign cases of Covid-19 may in fact lead to an increased likelihood of medical complications far into the future, for people of all ages. Professor Zimmet said: “This is a new game: we still don’t know very much about Covid-19, and it’s a learning process. We anticipate that this register will have a very important role globally.”

Dr Eleanor Kennedy, DRWF Research Manager said this is an important study that will add a lot to our understanding: “The interplay between diabetes and Covid-19 is increasingly complex so research like this will really help us to unravel still further the physiological phenomena that are at play here be they in people with pre-existing diabetes or newly diagnosed with the condition. This understanding will help us to future-proof the position as and when new variants of Covid-19 arise.”

Find out more about the CoviDiab Registry Project

Read Who can get the new Covid-19 vaccine?

As previously reported, almost one in three of all deaths from coronavirus among people in hospital in England during the Covid-19 pandemic have been associated with diabetes.

A follow-up NHS report confirmed that people living with diabetes are at a significantly increased risk if they get Covid-19 compared to people without the condition.

The breakdown of figures confirmed that people with type 1 diabetes who are diagnosed with Covid-19 are more likely to die from the illness than people with type 2 diabetes.

The news highlighted the importance for people with diabetes to self-isolate as much as possible in line with government Covid-19 lockdown guidelines.

The NHS is currently offering the Covid-19 vaccine to people most at risk from coronavirus 

The vaccine is being offered in some hospitals and hundreds of local vaccination centres run by GPs. An NHS statement said: “The coronavirus (Covid-19) vaccine is safe and effective. It gives you the best protection against coronavirus.”

The advice from NHS is “Wait to be contacted”.

The NHS will let you know when it is your turn to have the vaccine.

It is important not to contact the NHS for a vaccination before then.

The NHS has released guidance to update people on the safety of the covid-19 vaccinations being rolled-out across the UK.

Call to action - How you can support DRWF during this time

Sarah Tutton, Chief Executive of DRWF, said: “Research is the only way to find new treatments and a cure for diabetes. We have multi-year grant awards in place right now which we must do our utmost to honour and we must be able to react to ongoing applications that we receive for research work that could truly make a difference to the lives of people with diabetes. 

“We exist on voluntary donations and fundraised income and like most charities, Covid-19 has had a huge impact on our ability to raise the funds we need. We expect the months ahead will be just as challenging, and sadly this may have an impact on our ability to fund the volume and value of research work that could fuel the next big breakthrough.

“Charities need us, as we need them, more than ever before. Our supporters enable us to keep our research funding on track meaning that the diabetes research community has funds available to find the cure that could transform the lives of millions. We can’t thank our supporters enough for their continued support during these challenging times.”

Read Lockdown guidance for staying home and safe for people living with diabetes during Covid-19 pandemic

DRWF operations during the Covid-19 health crisis

The DRWF team is working remotely. Covid-19 guidance, particularly where it aligns or impacts with diabetes guidance, is shared as quickly as possible through the DRWF website and social media channels with the aim of making it as easy to understand as possible and a reliable source of latest news.

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