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A new study led by the consortium of top Indian diabetologists and endocrinologists outlined the five key factors that lead to complications in Covid-19 positive people with diabetes.
The report was published in the journal, Diabetes, and Metabolic Syndrome: Clinical Research & Reviews.
According to the report, the key factors that increase fatality among Covid-19 patients with diabetes are defects in T-cell immunity, baseline high levels of cytokines, and comorbidities such as obesity, coronary heart disease, hypertension, and chronic kidney disease, among others.
The experts stated that this is the reason why people with diabetes are more vulnerable to developing complications because of the virus.
Anoop Misra, who led the consortium of experts from across India said in a statement: “Diabetes does not raise the risk of getting coronavirus disease (Covid-19), but people with diabetes who get infected are at a higher risk of severe disease, complications, and death.
He added: “Previous studies have shown that 70 per cent of patients with diabetes in India have poor glycemic control, and many have diabetes-related complications. The paper has outlined five scenarios with implications on disease progression and severity that have been observed in patients since March, of which two are new.”
Misra, who is also the chairman of Fortis Center of Excellence for Diabetes, Metabolic Diseases and Endocrinology in New Delhi further added that people with undiagnosed diabetes can get full-blown diabetes after coronavirus. This can be due to an unhealthy diet, low or no exercise, use of steroids, and mental stress, among others.
“Our study from Delhi found 40 per cent people gained weight during the lockdown, with 16 per cent gaining 2-5 kg during 49 days of lockdown,” he noted.
Use of steroids
The researchers wrote in their paper that the unwarranted use of dexamethasone -- a steroid sometimes used for asthma, cancer, and rheumatoid arthritis -- in mild Covid-19 infection and other seasonal flu increases the risk of hyperglycemia.
High fasting blood glucose at the time of hospitalization in people not known to have diabetes puts them at higher risk for mortality than those who have normoglycaemia (normal blood sugar), it said.
Another scenario is hyperglycemia in pregnancy, which is a grey area in the absence of studies on pregnant women with diabetes and Covid-19.
Disruption of pancreatic cells
Another reason is a new onset of diabetes, which is now being reported during Covid -19 infection because Ace-2 (angiotensin-converting enzyme-2) receptors, in which the new coronavirus binds to enter human cells.
This can lead to the destruction of insulin-producing beta cells in the pancreas. Studies show 17 per cent Covid-19 patients have some disruption of pancreatic cells, among them insulin-producing cells, which leads to rapid deterioration of the condition.
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