Short term follow-up of patients presenting with acute onset diabetes and diabetic ketoacidosis during an episode of COVID-19. Issue 6 (November 2020)

• Record Type: Journal Article
• Authors: Kuchay, Mohammad Shafi; Reddy, Pavan Kumar; Gagneja, Sakshi; Mathew, Anu; Mishra, Sunil Kumar
• Is Part Of: Diabetes & metabolic syndrome. Volume 14:Issue 6(2020)
• Page Start: 2039
• Page End: 2041
• Publication Date: 2020-11
• Subjects: SARS CoV-2 -- COVID-19 -- Diabetic ketoacidosis -- DKA -- Coronavirus; Diabetes -- Periodicals; Metabolism -- Disorders -- Periodicals; Diabetes Mellitus -- Periodicals; Metabolic Diseases -- Periodicals; Diabète -- Périodiques; Métabolisme, Troubles du -- Périodiques; Endocrinologie -- Périodiques; Diabète -- Physiopathologie -- Périodiques; Diabetes; Metabolism -- Disorders; Electronic journals; Periodicals; 616.462
• DOI: 10.1016/j.dsx.2020.10.015
• Languages: English
• ISSNs: 1871-4021

Abstract

Abstract: Background and aims: Acute onset diabetes and diabetic ketoacidosis (DKA) can be precipitated by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in individuals with no history of diabetes. However, data regarding the follow-up of these individuals are scarce. Methods: Three patients (data of two patients already published) with acute onset diabetes and DKA, precipitated by coronavirus disease 2019 (COVID-19), were followed for 14 weeks to assess the behavior of the diabetes. Detailed history, anthropometry, laboratory investigations, imaging studies, clinical course and outcomes were documented. Results: Three individuals developed symptoms suggestive of SARS CoV-2 infection. After a few days, they were detected to have COVID-19 pneumonia, based on reverse transcription-polymerase chain reaction (RT-PCR) assay and chest imaging. In the meantime, they also developed acute onset diabetes and DKA, which were precipitated by COVID-19. They responded well to treatment, including intravenous fluids and insulin. After around one week, they were transitioned to multiple shots of subcutaneous insulin. After about 4–6 weeks, their insulin requirement diminished and oral antihyperglycemic drugs were initiated. At the last follow-up (14 months), they had controlled glycemia with oral antihyperglycemic medicines. Conclusions: COVID-19 can induce acute onset diabetes and DKA in some individuals with no history of diabetes. These features resemble type 1 diabetes. However, after 4–6 weeks, their requirement for exogenous insulin diminishes and respond to oral antihyperglycemic medications. Long term follow up is required to further understand the type of diabetes induced by SARS CoV-2 infection in these individuals. Highlights: In some individuals, COVID-19 induces diabetes resembling type 1 diabetes, characterized by acute onset and DKA. However, their requirement for insulin diminishes after around 4–6 weeks. Subsequently their diabetes can be controlled with oral antihyperglycemic medicines.