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Since the outbreak developed, there is a great deal of evidence suggesting that the new coronavirus will attack and affect multiple target organs of the human body.
mid-June, the New England Journal of Medicine published a joint warning from 17 diabetes experts around the world that the new coronavirus disease (COVID-19) could trigger new diabetes.
has been observed in a number of new coronavirus infections, regardless of past diabetes history, acute hyperglycemia has been observed.
September 2nd, Nature Metabolism published an associated case in which a 19-year-old male patient in Germany was diagnosed with insulin-dependent diabetes after being diagnosed as an asymptomatic infection with the new coronavirus and recovering.
While the report still struggles to establish a causal relationship between the new coronavirus and diabetes, a detailed analysis of the patient's course of disease and laboratory test results, including autoantibodies, further suggests that the new coronavirus infection may have a negative impact on the function of the pancreas, the organ that controls blood sugar levels in humans.
Screenshot Source: Nature Metabolism was admitted to the hospital with increased diabetes symptoms, according to the research team at the University Medical Center Schleswig-Holstein in Germany, a 19-year-old white patient who was admitted to the hospital's emergency department on May 5 because of weeks of unusual fatigue, fatigue, excessive thirst and increased urination and increased symptoms, as well as a significant weight loss of 12 kilograms.
blood tests showed diabetic ketoacidosis (DKA), blood sugar as high as 30.6 mmol/L (random blood sugar ≥11.1 mmol/L to meet the criteria for diabetes diagnosis), and glycation hemoglobin (HbA1c) as high as 16.8%.
addition to the signature indicator of diabetes, patients' β cell function also decreased, with serum C peptide levels as low as 0.62 μg/L (normal range of 1.1?g/L to 4.4?g/L).
based on symptoms and blood test results, the team speculates that the patient may have type 1 diabetes.
genetic factors and antibody testing suggest idepathic type 1 diabetes to learn more about the patient has a family history of diabetes, a cousin of the mother's family has autoantibody-positive type 1 diabetes, the patient grandmother is also a type 2 diabetes patient.
genetic test results suggest that the patient's HLA (human white blood cell antigen) genotype is DR1-DR3-DQ2 genotype, not a high-risk genotype for autoimmune diseases, although its genotype is indeed associated with a slight increased risk of autoimmune type 1 diabetes.
, however, many types of autoantibodies commonly found in patients with autoimmune type 1 diabetes were not detected in the body.
this information suggests that the patient is most likely type 1B diabetes, in other words, not autoimmune mediated, but idepathic.
the exact history of new coronary exposure, the researchers noted a new history of coronavirus exposure in the patient's family.
timeline of neo-coronavirus exposure and diabetes symptoms in patients (Photo: Reuters) 7 weeks ago, the patient's parents returned from a ski trip in Austria and developed typical symptoms of COVID-19.
the family did not test for antibodies until April 29.
tested positive for the new coronavirus IgG antibody on April 29 and the IgM antibody was negative.
Usually, IgM antibodies peak (about 1 week) earlier after the pathogen invades and then gradually decline.
IgG antibodies peak late (about 4 weeks) after pathogen invasion, but may be present in humans for months to years.
, the researchers speculated that the patient had contracted the new coronavirus 5-7 weeks before the hospitalization.
same time, the patient's identical twin neo-coronavirus antibody tested negative and never showed COVID-19 or diabetes-related symptoms.
patients were discharged after 10 days after being ruled out of other acute diseases and treated with insulin and type 1 diabetes.
discussion on the link between the new coronavirus and diabetes we already know that the new coronavirus enters human cells by binding ACE2, which is expressed not only in the lungs, but also in the body's pancreas β cells.
pancreas β play a key role in insulin production, and ACE2 is thought to be important β cell function.
same time, although the pathology of a typical type 1 diabetes is characterized by β cell damage caused by the autoimmune process, environmental factors, such as viruses, can also activate the immune system and even directly affect β cells.
the case of a variety of type 1 diabetes-related autoantibodies negative, the team believes that this case is more likely to cause new coronavirus infection directly caused by β cell damage, which in turn led to type 1 diabetes.
recent studies have also shown that adult pancreatic α cells β can be infected with the new coronavirus.
team noted that while this information is not sufficient to fully explain the causal relationship between new coronavirus infections and type 1 diabetes, it still supports this probability to a considerable extent.
Although a patient's high HbA1c at the time of treatment may indicate that he had type 1 diabetes before contracting the new coronavirus, diabetic ketoacidosis can lead to higher levels of HbA1c even in shorter courses.
, it cannot be ruled out that the patient is a recent acute onset of type 1 diabetes.
although diabetes is already a common chronic disease and has made great sci-sol progress in its diagnosis and treatment, we still do not fully understand the complex immunopathological mechanisms of type 1 diabetes.
, in just a few months, our knowledge of the new coronavirus and COVID-19 has been very limited.
There is no doubt that we need more epidemiological and experimental research to understand the potential link between new coronavirus infections and new diabetes, and more long-term case reviews to continuously supplement and expand our understanding of the far-reaching effects of new coronavirus.