Will Covid infection dependably trigger high glucose?

Seems like both infection and vaccination can cause glycemic issues.

Obviously a lot of factors/variables at play but interesting to read about.

Covid infection causing glucose abnormalities:

https://www.nature.com/articles/s42255-021-00508-2

Elevated HbA1cs following live attenauted vaccines which persisted after follow up in non-diabetics essentially making them pre-diabetic:

https://www.nature.com/articles/s41421-021-00329-3.pdf

Someone can in theory have problems with insulin resistance (increased need for insulin) that as of yet have not resulted in any blood glucose regulation impairment–it’s why the most sensitive tests now for T2 diabetes risk are testing insulin levels, not glucose. Someone with rising insulin is likely on the trajectory toward diabetes (especially without intervention), but if glucose numbers are entirely normal, not any kind of diabetic yet. Similarly someone can start to have increased variability in glucose response that still falls within normal ranges and itself poses no danger except that it likely indicates a progressive problem that will. For someone like that, it seems plenty feasible than an event like COVID infection could push them over a brink, despite genuinely not having been even technically pre-diabetic before (they probably wouldn’t even have any clue all that was going on if it were unless being very carefully monitored due to family history and particularly attentive doctors).

1 Like

I’m always suspicious of “glucose numbers … entirely normal,” which depends on their definition of the range of normal. I keep thinking of 98.6⁰ as the normal body temperature, which apparently hasn’t been accurate for 150+ years. Thanks for the new information - I know very little beyond Type 1.

mh

Mainstream medical diabetes diagnosis is gluco-centric and many doctors are reluctant to check insulin levels. This includes checking insulin levels also while conducting an oral glucose tolerance test (OGTT).

Elevated insulin levels can precede glucose failures by many years, even a decade or more. It’s the canary in the coal-mine if practitioners would just use it!

This test is known as the Kraft assay, named for Dr. Joseph Kraft who painstakingly kept hand-written records of thousands of people during the '70s and '80s. Here’s a video interview conducted of him a few years before he died.

1 Like

It always amazes me how much information seems lost over time like the Kraft test.

For me I think an AGP for a couple of weeks provides a pretty clear picture. With something like the Libre is pretty easy to do. One thing we do know is the first thing which goes is post prandial glucose control.

Maybe one good thing from Covid is all the research going into the virus impact on the beta cells. It seems in some cases its really messing up the beta cells which of course would result in increased insulin needs. We also saw the CDC announcement last week about the kids and diabetes after Covid which makes sense if Covid is messing up the beta cells.

National Institutes of Health (NIH) – 8 Jun 21

How COVID-19 Can Lead to Diabetes

Along with the pneumonia, blood clots, and other serious health concerns caused by SARS-CoV-2, the COVID-19 virus, some studies have also identified another troubling connection. Some people can develop diabetes after an acute COVID-19 infection…

A lot of good info is in the references in this document.

1 Like

Admittedly, I’m starting to fade out all things Covid, as I’m sure many other people are too… But that article actually was interesting.

Additional studies by the Jackson team suggest that the coronavirus may preferentially infect the insulin-producing beta cells. This also makes biological sense. Beta cells and other cell types in the pancreas express the ACE2 receptor protein, the TMPRSS2 enzyme protein, and neuropilin 1 (NRP1), all of which SARS-CoV-2 depends upon to enter and infect human cells.

I’m quite curious about this. Does that mean that healthy type 1s without any serious comorbidities, who are lacking beta cells, are actually better protected against Covid? Or maybe just recover better, because it’s harder for the virus to take root?

Of course, Covid insects other cells, too… But they did go out of their way to emphasize that “preferentially”, meaning that anyone without beta cells should be inherently better off.

We’re starting to see commentary that well-controlled diabetics are at lower risk for severe infection, but I assumed that was specific to other diabetics and high risk populations. Now I’m specifically questioning if our risk is lower than in an otherwise equivalent population. I doubt anyone is really compiling the data for that, with TIR, standard deviation, and A1c alongside all the other relevant stats, though. There’s just not a lot of data on well-controlled diabetics in general, since they’re so few and far between.

We’ve seen several reports here about mild Covid cases, but do we have any posters here who have required hospitalization?

I’m sorry that so many more people will potentially share our fate. But I can’t help but see the potential upside for those of us already living with diabetes. The more people diagnosed with the illness, the more money there is in the industry, which leads to advanced research. There’s also higher demand for “breakthrough therapy” designations from the FDA, so we could finally start seeing faster movement through the system of new medications and devices.

I can only speak for my one experience.
I had covid so early no one thought it was covid.
I had a chest x ray due to a car accident which showed lung nodules.
I was tested a few weeks later for the covid antibodies and I was positive.

I was barely sick. I had fever for three days and a mild cough.
But that was back so far it was the alpha version.

There are too many variables and only one case I can consider.
I don’t think we can say type1 actually protects us. At this point

I don’t think the T1 is better protected from Covid but the T1 is much more aware of BG control so if they start seeing they need more insulin they adjust as needed. How much beta cell functionality if any the T1 had prior to Covid is going to vary by each T1. This of course goes back to the original question - will Covid dependably trigger high glucose which depends on beta cell impact.

UPenn before Covid use to run educational sessions for T2s which on occasion I would attend. One truth from those sessions was most of those T2s attending did no daily BG testing and they would usually say their doctors never mentioned daily testing. Most of course were on some type of antiglycemic and not insulin. If the T2 is pretty unaware of their daily BG then the average “Joe” without diabetes really has no idea. If Covid has attacked their beta cells they would have little idea. BTW - the way they started finding out about the kids getting diabetes after Covid was they are being hospitalized with DKA.

A lot of the study data in these papers is being collected through autopsy. How bad Covid is effecting the beta cells of the surviving general population be them T1 or not is pretty much an unknow except some T1’s are seeing the need for more insulin. But then again the only ones really watching their daily insulin needs are the T1s and insulin dependent T2s.

An interesting outcome of these studies is they seem to be seeing ISRIB can reverse the transdifferentiation process. If true then the obvious question is can this also be applied to the general T1 population in humans? At this point that answer is probably years away.

I had no jumps after any of my 3 vaccines or when I had covid!