COVID may be causing its own hybrid of diabetes, scientists fear.
Diabetes is generally either type 1 or type 2. But Covid survivors are presenting with a combination of the two.
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The condition affects up to 15 per cent of people previously infected with the coronavirus, research has shown.
Some have risk factors for the condition, such as obesity or family history, and the coronavirus may have triggered it.
But others develop diabetes to the surprise of doctors.
Scientists are struggling to pin the underlying mechanisms that lead to diabetes in Covid patients.
Diabetes already affects 422 million people globally, four times higher than in 1980, according to the World Health Organization.
It is incurable and needs lifelong management with medication and lifestyle adjustments.
Francesco Rubino, a diabetes surgery professor at King’s College London, told the Washington Post: “There’s a good chance that the mechanism of the diabetes isn’t typical. There could be a hybrid form. It’s concerning.”
Prof Rubino started a global registry of COVID-19 patients who later developed diabetes, looking to find commonalities between cases.
He said some of the cases do not fall into either type 1 or type 2.
In type 1 diabetes, people can’t make their own insulin, which is needed to regulate blood sugar.
Their body attacks the cells in the pancreas that make insulin, called beta cells.
People with type 2 diabetes people can make their insulin but it’s either insufficient or their bodies reject it.
Type 2 diabetes accounts for 90 per cent of cases and is largely linked to poor diet and lack of exercise – which is why cases have soared in recent decades alongside rising obesity levels.
Prof Robino said: “We really need to dig deeper. But it sounds like we do have a real problem with Covid and diabetes.”
How many are being affected and why?
An analysis of research so far has found that up to 14.4 per cent of people hospitalised with Covid developed diabetes.
The findings, published in the journal Diabetes, Obesity and Metabolism, looked at 3,700 patients across eight studies.
In each study, between 5.9 per cent and 25.8 per cent of people ended up with a diabetes diagnosis after suffering severe Covid.
Only one study reported the type of diabetes that patients had been diagnosed with.
The researchers discussed what could be causing the condition, and said the coronavirus could attach to beta cells in the pancreas and impair the secretion of insulin.
The virus enters cells by attaching to a receptor called ACE-2, which is found on the surface of pancreatic cells.
The paper added the coronavirus “may also injure the beta cells by triggering inflammation”.
And it noted one study in which the coronavirus entered and damaged beta cells that were grown in the laboratory.
The authors concluded: "We now have the situation of arguably the two major pandemics of the 21st Century colliding."
Another study conducted by Leicester University found that of 47,780 Covid patients hospitalised in the first wave, 4.9 per cent ended up with a diagnosis of diabetes.
Kamlesh Khunti, professor of primary care diabetes and vascular medicine at Leicester University and author of the study, which was published online as a pre-print, told The Telegraph: “We don’t know if it’s because Covid destroyed the beta cells which make insulin and you get Type 1 diabetes, or whether it causes insulin resistance, and you develop Type 2, but we are seeing these surprising new diagnoses of diabetes.”
Diabetes UK says on its website: "The evidence to suggest coronavirus could trigger type 1, type 2 – or even a new type of diabetes – is growing.
"But we need to keep in mind that from the type of research studies that have been done so far we can’t be sure if coronavirus is directly causing any new cases of diabetes, or whether there are other factors that could explain the link."
Diabetes is already growing in case numbers at an alarming rate worldwide.
If left uncontrolled, the disease can damage many parts of the body.
It is linked with serious complications including heart disease, stroke, blindness, kidney failure, nerve damage and limb amputation.
Meanwhile it has become increasingly evident that Covid will cause even more pressure on the NHS in the future by causing long term health problems for survivors.
Although a respiratory illness, the coronavirus often leads to problems in the heart, blood and brain.
Some of the effects are long lasting, causing so called "long Covid".
The NHS has had to set up more than 60 clinics so far to cope with the wave of long haulers suffering breathlessness, brain fog, fatigue and a racing heart rate.
The study by Leicester University also found increased rates of heart problems and chronic kidney or liver disease.
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