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A closer look at post-Covid diabetes

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(Bloomberg) — Diabetes was identified as a risk factor for developing more severe disease from Covid-19 soon after this surgery. What still puzzles doctors two years later is the unexpected appearance of the metabolic condition in covid patients weeks or months after contracting the coronavirus.

The causal link between covid and type 2 diabetes was reiterated in research from the US and Germany this month.

A study of more than 180,000 users of the US Department of Veterans Affairs health system who survived the first month of a covid outbreak found that they were 40% more likely to receive a new diagnosis of diabetes during the the following year than a “control” group that avoided the virus. That equates to about 13.5 additional cases of diabetes for every 1,000 Covid patients, according to the study, published Monday in The Lancet Diabetes & Endocrinology.

“The risks were apparent even in people who were at low risk of diabetes before contracting COVID,” said study co-author Ziyad Al-Aly, chief of research and development at VA St. Louis Health Care System and a clinical epidemiologist at the University. of Washington in Missouri. The likelihood of diabetes increased with the level of care Covid patients received, and those admitted to the ICU were more likely to receive a new diagnosis of diabetes, the condition in which the body does not produce enough insulin or does not use it properly.

The study from Germany found that Covid patients, most of whom have a mild form of the disease, are 28% more likely to be diagnosed with type 2 diabetes than a comparison group of patients who have a heart infection. upper respiratory tract caused by a different virus. That study, published March 16 in the journal Diabetologia, was based on an analysis of electronic records from a nationwide primary care database that followed patients, including nearly 36,000 COVID cases, for three to five years. months

Type 2 is the most common form of diabetes and is related to obesity and usually develops gradually. Follow-up studies are needed to understand whether the condition that occurs after mild Covid is only temporary and can be reversed after patients fully recover, or whether it leads to chronic disease, the researchers said. If confirmed, their results indicate that patients should be screened for the condition even after a mild case of Covid, they said.

Covid can trigger diabetes in previously healthy people and amplify known risk factors for people who are already predisposed to developing the disease, Al-Aly said. His data is based on older white men, which limits the generalizability of the findings to a broader population.

Still, studies other than the one from Germany have shown similar cartridges.

Another hypothesis is that insulin production is disturbed by viral damage to cells that repair the vessels that supply blood to the pancreas, said Gaetano Santulli, an associate professor of medicine and molecular pharmacology at Albert Einstein College of Medicine in New York.

Whatever biological mechanisms are involved, experts have advised that the link between the coronavirus and diabetes could be extremely costly and deadly. About seven million people die each year from diabetes. That means about one person every five seconds. Health spending for diabetes among people aged 20 to 79 years soared to $966 billion last year from $232 billion in 2007, and now accounts for about 11.5% of global health spending for life-shortening complications, which they range from strokes and kidney failure to foot ulcers and blindness.

original note:

Coronavirus Daily: A Closer Look at Post-Covid Diabetes

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