Skip to main content

COVID-19 And Diabetes: A Link to Look For in the Future?

 

4 months into the COVID-19 pandemic, we are finally starting to see some of the consequences of an infection with the SARS-Cov-2 virus. While the deadly virus wreaks obvious havoc on the respiratory system of its victims, there are many other body systems that the virus seems to have an effect on, namely the endocrine system.

The endocrine system is a complex series of glands located in various portions of the body that produce and secrete hormones. The body uses these hormones for many functions from respiration to reproduction.

One of the most important functions of the endocrine system is blood sugar regulation and digestion or the breakdown of ingested food stuffs to create energy your body can use. When you think about the endocrine system, your first thought probably isn’t one of keeping blood sugar in check or digestion. After all, that’s what the gastrointestinal system does, right? While this is true, one of the most important endocrine (and exocrine) glands of digestion and blood sugar regulation is the pancreas.

The pancreas is a long flattened gland located in the abdomen. As stated above, the pancreas functions as both an exocrine gland (secreting hormones through ducts) to aid in digestion and an endocrine gland (secreting hormones directly into the blood stream) to regulate blood sugar.

The pancreas plays a role in both raising and lowering blood sugar with glucagon and insulin respectively. Clearly, this is an important gland for the proper functioning of the body.

What happens to the pancreas during a COVID-19 infection?

There is evidence that SARS-CoV-2 virus affects both the exocrine and endocrine functions of the pancreas by attaching to ACE 2. Angiotensin-converting enzyme 2 is an enzyme that helps to lower blood pressure by catalyzing the hydrolysis of angiotensin II to angiotensin, a vasodilator, which relaxes smooth muscle cells leading to the widening of blood vessels.

ACE 2 is highly expressed in the pancreas with mRNA levels being higher in the pancreas than the lungs [1]. Since the SARS-CoV-2 virus binds to ACE 2 to gain entrance into the cells, there is a very real concern that a COVID-19 infection would affect the pancreas and it’s function. In fact, there is evidence suggesting that a COVID-19 infection causes or contributes to mild pancreatitis in patients with both mild and severe COVID-19 cases [2].

While the research and clinical efforts to understand the course of a COVID-19 infection and its sequelae, have been reasonably focused on respiratory health, there is evidence suggesting that we can’t ignore a probable link to pancreatic dysfunction and quite possibly diabetes. For example, a glycemic characteristic study of 1122 hospitalized COVID-19 patients reported that 257 patients had uncontrolled hyperglycemia which was defined as two or more capillary blood glucose tests greater than 180 mg/dl with A1C < 6.5% or no A1C testing [3].

While this finding could suggest that these were patients who were unaware of their diabetic status, it is possible that it was caused by COVID-19. After all, ACE 2 dependent damage of pancreatic exocrine and endocrine tissue, elevations in fasting glucose, and development of diabetes during hospitalization have been reported with COVID-19 [4]

At this time, SARS-CoV-2 is not indicated as a virus that leads to the pathogenesis of type 1 diabetes but that could very well change in the future as we gain understanding of this virus with more research and a clinical focus on the course of this disease on the pancreas.

In time, we may find that SARS-CoV-2 could be a potential environmental trigger for the development of T1DM due to direct β-cell damage and changes in self-antigens and immune-mediated destruction of the β-cells of the pancreas [5]. It could also exacerbate the course of disease in type 2 diabetics. We are already aware that patients with a previous diagnosis of diabetes have a much higher incidence of severe and critical cases of COVID-19 infection than non-diabetics [6].

But could future research suggest that a COVID-19 infection causes those with metabolic syndrome to cross over the threshold to become type 2 diabetes?

Only time will tell.

In the mean time, what should we be looking for? Is there anything that can be done to monitor the health of those who are diabetic or at a high risk for a COVID-19 infection? Firstly, having the fasting blood glucose tested regularly is a good idea.

How often depends on certain risk factors.

Harvard health suggests that those with diabetes risk factors including age older than 45, sedentary lifestyle, BMI of 25 or higher, and an African-American, Hispanic, Native American, or Asian American heritage get tested. If the results are within normal range, it is recommended that tested is repeated every 3 years. If abnormal, annually [7].

Also consider having glycated hemoglobin (HbA1c) tested. A hemoglobin A1c is hemoglobin with glucose attached and it shows the average blood glucose levels of an individual over the past 8 to 12 weeks.

Another important test to consider is high-sensitivity C-reactive protein, or hs-CRP. CRP is a protein made in the liver that is sent into the bloodstream in response to inflammation. Unlike a CRP test, hs-CRP is a more sensitive test that measures the amount of general inflammation throughout the whole body.  While hs-CRP has been linked to cardiovascular and heart disease, there is strong research showing that elevated hs-CRP levels is linked to an increased risk of a later development of diabetes [8,9.10].

When it comes to diabetes prevention and protection, especially during this COVID-19 crisis, knowing triglyceride levels is essential. Triglycerides are a type of lipid found in the body that acts as energy stored in the fat cells. High triglyceride levels indicate not only a diet high in carbohydrates but also insulin resistance [11], a precursor to diabetes.

While this may seem like a large number of tests, all of these tests can be ordered under a convenient high-quality pre-diabetes panel offered by AYUMETRIX, the world’s leading and most advanced hormone testing laboratory .

Knowing the level of risk for diabetes is important when it comes to navigating the nuances of COVID-19. In the future, we may see that COVID-19 played an important role in emerging cases of diabetes and/or in the exacerbation of it. Screening for diabetes, earlier rather than later, could quite possibly play a pivotal role in the shaping the health outcomes of those who have suffered a COVID-19 infection.

 

Candace Mathers, ND, MSAc

Contact information: info@ayumetrix.com

 ayumetrix.com

References

1.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195612/

2.https://www.medrxiv.org/content/10.1101/2020.02.28.20029181v1

3.https://journals.sagepub.com/doi/full/10.1177/1932296820924469

4.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195612/

5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242186/

6.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195120/

7.https://www.health.harvard.edu/diseases-and-conditions/how-often-should-you-get-your-blood-sugar-checked-

8.https://www.ijcmsr.com/uploads/1/0/2/7/102704056/ijcmsr_199_v1_1.pdf

9.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4542275/

10.https://care.diabetesjournals.org/content/26/5/1535#:~:text=High%20CRP%20levels%20have%20been,diabetes%20(8%E2%80%9310).

11.https://pubmed.ncbi.nlm.nih.gov/15925013/


Labels:

Comments

Post a Comment

Popular posts from this blog

COVID19 and Thyroid Dysfunction: Is There a Connection?

6 months into the COVID19 pandemic, we are still learning new things about this deadly virus. For example, COVID19 infections are now linked to varying symptoms from gastrointestinal distress like diarrhea to chilblains, inflammatory itchy irritations or sores on the hands and feet [1]. There are even reports that a number of COVID19 survivors, who and are still experiencing long term effects from the infection, are noticing hair loss [2].   With COVID19 having such a far reaching detrimental effect on the body and virtually all of its organ systems, it is warranted to take a deeper look into how a COVID19 infection can affect the endocrine system, especially the master gland of metabolism, the thyroid.   The thyroid is a butterfly shaped gland located at the base of the neck which is responsible for the production of powerful hormones like triiodothyronine (T3) and thyroxine (T4). These hormones are responsible for many processes in the body, namely maintaining optima...
Post a Comment
Read more

Food Sensitivity Testing: An Answer to Unexplained Symptoms?

  Food is a huge part of the human experience. We not only need food to stay health and fuel our energy needs, it also contributes to our feelings of community, shapes our society, and even identifies us with our culture. But for some, food is an obstacle wrought with many challenges. Food allergies are an unfortunate part of many children and adults’ lives with the prevalence of food allergies increasing in the United States. One JAMA study noted that almost eleven percent of adults surveyed had a food allergy and that at least half of those surveyed had at least one food allergy that first appeared in adulthood [1]. Undoubtedly food allergies are a burden for a sizable amount of the adult population. Children don’t fare much better when it comes to food allergies. According to FARE, the Food and Allergy Resource and Education Institution, eight percent of children suffer from food allergies [2]. The most common food allergies most often centered around peanuts, shellf...
1 comment
Read more