Det är välkänt att diabetes är en riskfaktor för Covid-19, men det omvända verkar också gälla.
I UK är ungefär 25% av de som behöver sjukhusvård för Covid-19 diabetiker. Men det verkar också vara så att Covid-19 kan skada de insulinproducerande cellerna, så att man kan utveckla diabetes av virusinfektionen.
Många som anländer till sjukhus med svår Covid-19 har skyhöga blodsockernivåer. En antydan om att insulinmekanismen inte fungerar som den ska. För en del av dessa blir tillståndet kroniskt.
Forskning har visat att ACE-2, proteinet/ receptorn som Sars-Cov-2 binder till när det kommer in i den mänskliga cellen, inte bara finns i lungorna. ACE2 finns också i organ och vävnader som är involverade i glukosmetabolismen – såsom bukspottkörteln, tunntarmen, fettvävnaden, levern och njurarna. Experter tror att viruset kan orsaka flera olika och komplexa dysfunktioner av glukosmetabolism genom att komma in i dessa vävnader. Och därmed leda till diabetes.
Men det behövs betydligt mer forskning för att nå ett avgörande svar kring detta. En global databas, CoviDiab Registry-projektet, inrättades i början av juni för att samla information om Covid-19-patienter med höga blodsockernivåer.
Mer via https://4health.se/?s=corona
Not only may diabetes make a coronavirus infection worse, but Covid-19 may also trigger the onset of the chronic condition in some people, emerging evidence suggests.
It is well known that underlying health issues increase the likelihood of severe illness or death after contracting the coronavirus.
In the first two months of the UK’s outbreak, roughly 25 per cent of people hospitalised with Covid-19 with already had diabetes, suggesting that the risk of severe illness among diabetics was four times higher than for the general population.
But Paul Zimmet, a professor of diabetes at Monash University in Melbourne, told Nature that “two pandemics could be clashing”, with Covid-19 also damaging the cells responsible for producing the hormone insulin.
He said that dozens of patients suffering from severe Covid-19 have arrived at hospital with very high blood sugar levels – a sign that the body is not producing enough of the hormone.
A handful of these patients have gone on to rapidly develop the chronic condition, where the body produces either no insulin at all, or not enough to work effectively.
The theory has some precedent as other viruses are known to precipitate autoimmune diseases, including type 1 diabetes. A paper published in Acta Diabetologica journal in 2009 found that damage to the body caused by Sars, a close cousin of the virus that causes Covid-19, triggered the onset of diabetes in some patients.
More recently, an experimental study in miniature lab-grown pancreases published in the Lancet last week concluded that a Covid-19 infection “could induce new onset diabetes” by damaging the cells responsible for control blood sugar levels.
The findings have not been confirmed in humans and it is unclear whether Covid-19 plays a direct role in the reduced production of insulin.
But on June 12, a group of 17 leading diabetes experts wrote a letter published in the New England Journal of Medicine warning that new-onset diabetes is being observed in some patients who have tested positive for the Covid-19.
Research has shown that ACE-2, the protein that Sars-Cov-2 binds to as it enters the human cell, is not only located in the lungs. It is also in organs and tissues that are involved in glucose metabolism – such as the pancreas, the small intestine, the fat tissue, the liver and the kidney.
Experts believe that by entering these tissues, the virus may cause multiple and complex dysfunctions of glucose metabolism, triggering diabetes.
But there are warnings that considerably more research is needed to reach a conclusive answer. Experts hope for clarity in the coming months after a global database, dubbed the CoviDiab Registry project was established in early June to collect information on Covid-19 patients with high blood-sugar levels.
“As has been stated, we’ve not encountered a virus like Sars-CoV2 before for the breadth of disease it causes,” Prof James Hildreth, president of Meharry Medical College, said. “Now evidence [is] accumulating that Covid-19 virus may cause diabetes. Clearly suggests that people who are pre-diabetic or diabetic should definitely avoid Covid-19 infection.”
https://www.nature.com/articles/d41586-020-01891-8
https://www.sciencedirect.com/science/article/abs/pii/S2213858720301522
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