
Mounting clues suggest the coronavirus might trigger diabetes - sohkamyung
https://www.nature.com/articles/d41586-020-01891-8
======
peteyPete
Those who suffer from the virus can also develop a host of other things. Look
up how many people developed ME/CFS (Myalgic encephalomyelitis/chronic fatigue
syndrome) post SARS and how many are experiencing the same symptoms after
"recovering" from COVID-19. Some are months into their recoveries with no
signs of going back to their old normal.

I wish it was talked about more instead of people dismissing the fact that if
a large percentage of those who get severe symptoms develop chronic illnesses,
this is going to be a lot bigger than "just a flu". It far from just a flu. My
significant other happens to be a SARS survivor who's been dealing with
chronic illness since "recovering" from the infection in 2003. I wouldn't wish
that on anyone.

I hope diabetes isn't yet another condition that many will develop after this.

~~~
PaulKeeble
People have already started appearing in various chronic illness forums around
the world with what sounds very much like ME/CFS after having caught Sars2.
The official diagnosis takes at least 6 months of having the symptoms and its
notoriously badly diagnosed throughout the world due to the incredibly flawed
PACE study that painted it as a physchological disease.

Doctors need to be quickly educated on the known blood bio marker combination
(igG, lymocytes 2% and antibody complexes all abnormal) until the Stanford
nano needle salt stress test is developed and released. They need to ensure
patients are put onto a pacing regime which will slow the rate at which they
get worse.

Many epidemics have caused ME/CFS "outbreaks" and it has no treatment and
almost no research has even been done. 5% of people recover but some also die,
most are broken for life. Doctors often think its diabetes as it presents with
similar systemic issues but the insulin tests usually come up fine. Its
critical they do immune system and full thyroid tests and get the diagnosis
and the treatment correct early as each over exertion will permenantly degrade
their patients energy levels.

~~~
scruple
Can the asymptomatic who never present symptoms, or those whose symptoms don't
land them in a testing facility / hospital, also develop these chronic
illnesses? Is that known?

~~~
PaulKeeble
About 80% of ME/CFS patients know the day they caught the virus that caused
their ME/CFS, but the other 20% don't. Whether that is because 20% of
sufferers have a completely different trigger circumstance or because they
were asymptomatic is unknown, like I said there has been almost no research in
70 years since the first outbreak was classed as mass hysteria and its been
ignored and patients abused ever since until the last 2 years when research
finally started to trickle in and get funded.

------
zaroth
I am not a doctor but both my kids are T1D so I am quite familiar with it.

This part stood out to me;

> _In most people with type 1 diabetes, the body’s immune cells start
> destroying β-cells — which are responsible for producing the hormone insulin
> — in the pancreas, often suddenly. In Gnadt’s case, Hollstein suspected that
> the virus had destroyed his β-cells, because his blood didn’t contain the
> types of immune cells that typically damage the pancreatic islets where the
> β-cells live._

If the virus damages the islets it could suppress insulin production, but
without an autoimmune response there’s reason to be hopeful that the damage is
only temporary and that the pancreas can recover.

TFA says that whether the virus directly attacks cells or induces an immune
response, and whether the damage is permanent or not, are both areas under
active investigation.

~~~
zaroth
I will add that it's very common for what doctors believe to be "latent" T1D
to be "triggered" by a viral episode.

The theory is that the body is somehow primed to have the auto-immune
response, and that it is essentially inevitable, but it takes some unrelated
stress/immune response to kick off the cascading failure.

In that regard it wouldn't be surprising to see the typical rate of T1D
diagnosis just happening to be triggered by the currently predominant virus,
i.e. COVID, but in that case you would expect to see the tell-tale antibodies,
and the overall incidence rate of T1D in the population would not spike.

------
jvm_
[https://www.reddit.com/r/COVID19positive/](https://www.reddit.com/r/COVID19positive/)

Is full of people with long duration recovery periods _.

_ Caveats are that only people with long duration symptoms would find that
place and post there. Also, it could just be something else that the person is
blaming on their Covid diagnosis.

Given the volume of posts on long term recoveries, it seems likely that
there's more impact than a normal get-sick-for-3-days flu.

~~~
puranjay
I really wonder what the long term economic impact of a chronically fatigued
population will be. It's clear by now that a) the virus isn't going away, and
b) a lot of, if not most, people will get it.

If a substantial portion of the infected also develop a host of long term
health issues, what's going to be the economic cost?

We seem to have been focusing on deaths as a key metric which has made a lot
of younger people complacent. Apart from anecdotal accounts, I have seen very
little reporting on the long term health effects among survivors

~~~
SpicyLemonZest
There's just no way to really measure long term health effects at this point,
because the vast majority of infectees aren't past the normal timeline for
full recovery from a serious disease. (Fatigue reports in particular
_probably_ shouldn't be concerning, since post-pneumonia fatigue is known to
continue for 3-6 months.)

~~~
Loughla
That's what has been so confusing for me to sort out. COVID seems, according
to what I can see, to have an extra-long recovery period for many people.

I had walking pneumonia and bronchitis two years ago, and even with treatment
it took a good 5 months to get out from under that in anything near 90%
capacity.

Is COVID that? Or is it worse? This gives me more anxiety than the deaths, to
be honest.

~~~
thaumaturgy
There is as yet insufficient information on exactly what covid19 does to our
biology, and consequently there is a lot of guesswork and misinformation
flying around. Researchers are in hair-on-fire triage mode, there's an
enormous amount of pressure to just "figure it out", people keep forgetting
that the first word for this infection's official name is "novel", and they
keep likening it to things that they do understand even though it's not really
any of those things.

So we don't know. Nobody does right now. It takes time. It is _really_
unfortunate that it keeps getting compared to other diseases. It's a lot like
encountering malaria for the first time and saying "it's basically yellow
fever". We should be behaving as though there's a mysterious new illness
sweeping through populations across the world, with unknown short-term and
long-term effects, because that's exactly what's happening.

The earliest severe cases all presented as pneumonia, so this disease got
treated that way. But, it was quickly discovered that the pneumonia didn't
behave quite like normal cases of pneumonia, and then shortly after that,
there turned out to be a strong correlation with cardiac and stroke events.
So, although people still think of this as a respiratory disease, there is
_something_ else going on, we just don't know what yet.

------
makecheck
While the general response to COVID-19 is already infuriating for so many
reasons, it’s especially frustrating to see people think it’s “OK” to get it
since they’ll probably “recover”.

It needs to be drilled into people of all ages that “recovery” is terrible
terminology. Congratulations, maybe you didn’t die but you still may very well
develop _lifelong_ conditions that really screw up your body and your
lifestyle (and, if that’s not enough, consider the healthcare costs).

Furthermore, if a person’s only complaint about pandemic rules is their
“inconvenience”, it’s time to grow up. No one owes you convenience, and this
is definitely the point in your life to figure out how to do what’s better for
society. Put on a mask. Follow the rules. And learn more about this, from
actual health professionals, not politicians with mile-long track records of
lying.

~~~
closeparen
If you live alone, "follow the rules" means "do not come within six feet of
another human being any time in the next several years." That is a heavier
psychological burden than most people will ever carry in their lives. It
doesn't serve anyone to trivialize it.

~~~
switch007
Well put! These preachy “just follow the rules” kind of comments garner lots
of upvotes but completely underplay what it means to be human.

------
neuronic
In general we have to look much closer at viruses causing chronic illnesses or
autoimmune disorders.

Epstein-Barr Virus (EBV) is another one where lots of ailments seem to follow
- I speak from personal experience combined with many reports both online and
acquiantances.

Ever since having mono/kissing disease/EBV my body hasn't been remotely the
same.

~~~
1996
Me too! It was very serious. Years later I'm still tired. Do you have any
links or suggestions? I'm down for anything that may help.

~~~
ryanar
I have had the same experience. I accidentally drank another person's water
bottle at the gym after a set, a few weeks later I had Mono. I have never had
the same energy level that I used to have. I used to love working out and had
so much energy, that is all gone.

------
asdfasgasdgasdg
This would be bad, but effect sizes are important. If it imposes a 1/1000
incremental odds of developing diabetes, that would be terrible, but not as
bad as its 1/100 incremental odds of death.

~~~
khuey
If the deaths come to people who are elderly or otherwise close to death
anyways and the diabetes comes to a bunch of otherwise healthy 18 year olds
the impacts could be different than mere effect sizes would indicate. (Type 1
diabetes is like -10 years to life expectancy).

------
nradov
It's possible that SARS-CoV-2 isn't unique in that regard. We don't know
whether other viruses might also cause the same damage because we haven't
really looked. We know some of the risk factors for diabetes such as obesity,
but patients with similar known risk factors have different outcomes. Maybe
other viral infections are a missing factor?

~~~
0x8BADF00D
The strange thing about SARS-CoV-2 is that viral load varies in human tissue.
You could have small concentrations of SARS-CoV-2 in cardiomyocytes, for
instance.

~~~
nradov
How is that strange? Many different viruses can cause some level of
myocarditis while also infecting other tissues to varying extents.

~~~
0x8BADF00D
I've never read of any type of coronavirus causing myocarditis and heart
failure in patients. Also have never read of coronavirus being present in
other locations of the body, other than nasal/sinus area and lungs.

------
subsubzero
T1 diabetes is a strange disease, my brother has it and he was not remotely
over-weight although in college and after, his diet was terrible(he also was
extremely vitamin D deficient from avoiding the sun). He developed it in his
late 20's. Another friend has it and he got it as a kid, he said it came on
after a very bad bout of pneumonia he had beforehand, and his Dr's think that
is what may have triggered it but who can say. Perhaps either a extremely hard
illness or a vitamin deficiency can bring it on, covid-19 seems to fit the
bill with accounts of people with low vitamin D levels getting more severe
cases, and the fact that it attacks the entire body looking for weaknesses.

~~~
Trasmatta
> he was not remotely over-weight

That's not surprising at all, since there's no correlation between weight and
T1D.

~~~
drocer88
From
[https://academic.oup.com/edrv/article/39/5/629/5060447](https://academic.oup.com/edrv/article/39/5/629/5060447)

"Obesity, once rare in type 1 diabetes (T1D), is now an increasingly frequent
problem (3–5). Accumulating evidence on the prevalence and consequences of
obesity in T1D shows very clearly that this comorbidity is both
underappreciated and poorly understood." .... " The considerable obesity
burden in youth with T1D was confirmed, also in the T1DX, where the prevalence
of obesity (BMI ≥95th percentile) was 13.5% in adolescents (mean age 15.4
years), with higher prevalences in those of black/African American descent
(17.9%) and Hispanic/Latino descent (15.9%) between the years of 2010 and
2012."

~~~
milesvp
My suspicion from diabetic research I did both prior and during my wife’s
gestational diabetes, is that the increase in obesity that may have occurred
in the last 60 years is due to bad dieting advice for T1 diabetics.

The fundamental health issue with diabetes is managing blood glucose levels.
This is best done with low carb meals with slow carbs along with small amounts
of periodic insulin. But for some reason common advice for diabetics is to eat
large amounts of fast carbs and then take large doses of insulin. This
combination is just begging for added weight (and increased risk of insulin
sensitivity to boot).

~~~
Trasmatta
> But for some reason common advice for diabetics is to eat large amounts of
> fast carbs and then take large doses of insulin

That's odd, I've been diabetic for about 10 years now and have never heard
this advice from any doctor or dietician that I've seen.

~~~
beagle3
Are you in the US?

I've heard from several americans that this was the recommended ADA advice
(luckily changed at some point in the last 5 years or so).

However, outside the US it seems that the recommendation has always beem to
minimize carbs.

~~~
entitydc
I’m in the US, and all of the advice I’ve recovered from every doctor and
nutritionist is to limit carbohydrates. You can “cover” as you put it, and
you’re trained to be able to do that when the situation arises, but the
baseline diet that I was given is certainly low carb by comparison to typical
diet recommendations (not ketogenic, but far from “eat whatever you want”).

While I’m sure there are plenty of nurses and doctors out there giving rushed
and questionable advice, I’d be surprised to find that this advice is “common”
(though many patients may “hear what they want” so to speak).

~~~
beagle3
See e.g. [https://feinmantheother.com/2013/12/27/american-diabetes-
ass...](https://feinmantheother.com/2013/12/27/american-diabetes-association-
embraces-low-carbohydrate-diets/) \- but you have to read at least until the
middle (spoiler: this blog post is from 2013, but the recommendations therein
were only embraced 2019 or so).

Author is a professor of biochemstry, who is quite well known as a good
scientist (but it's likely much of his name recognition comes from sharing a
similar sounding name to a more famous person ....)

------
machinehermit
I am overweight, love candy, chocolate, ice cream, both sides of my family
have a history of diabetes.

How could you possibly tease out that covid triggered diabetes in me when I am
doing such a good job myself?

~~~
rsynnott
The article suggests it might trigger type 1. You're mostly risking type 2.

~~~
UnpossibleJim
There seems to be a growing movement to have two different public facing names
as, more and more, people are having trouble parsing out the difference in the
written and spoken media, which often just uses the singular term, "diabetes".

------
dminor
My wife's cousin's husband developed type 1 diabetes (at 40) after he and his
family got over a flu-like illness a couple months ago.

They tested negative for covid but this makes me wonder.

~~~
makomk
Apparently the flu might be able to cause type 1 diabetes too:
[https://www.newscientist.com/article/dn22456-diabetes-
linked...](https://www.newscientist.com/article/dn22456-diabetes-linked-to-
flu/) (In general, it seems like other viruses have a lot of odd and rare
effects that just don't get as much attention as anything involving Covid-19,
giving the dubious impression that it's somehow different from other viruses
in this regard.)

------
underdeserver
This thing is really, really bad.

~~~
pvarangot
A lot of viruses trigger T1D, this thing is mostly getting a lot of press and
researchers attention. It's also so contagious that we are getting
unprecedented streams of data from symptomatic and asymptomatic patients.

SARS was worse with the consequences but less contagious.

------
nico_h
So many caveats missing from this title and the article it feels like click
bait. (It worked, I clicked). Are there per-existing conditions? What is the
prevalence of this effect?

How long does this conditon last?

It can’t be that frequent if it took 6 months to find enough cases. It’s like
the Kawasaki-like syndrom in kids with COVID-19. It happens, but what is the
prevalence?

Just anecdata in the article and « we need more study »

------
jb775
I think it's more likely that people already on the verge of "triggering"
diabetes are simply more likely to catch coronavirus due to their general poor
health and therefore weakened immune systems. Or at least they're more likely
to be symptomatic.

------
veridies
Serious question: is it possible that part of the increased mortality for
(type 2) diabetics is a result of high blood sugars caused by this kind of
effect?

------
m0zg
Mounting clues suggest the entire field of medicine has no clue whatsoever.
You can't trust anything without waiting for 2-3 months to see if there's a
retraction, and maybe not even then. I will start paying attention when they
figure out, once and for all, whether eggs and butter are good or bad for me.

------
xivzgrev
This shit is scary. It’s bad enough tjat it’s contagious like flu and has a
given mortality rate. But now some people are developing chronic conditions
after it, like diabetes here. I also read about asthma or other lung
conditions.

That shit is enough to make me stay at home forever. Then when I do go out I
see people not being socially distant, no masks, etc. hope they don’t get this
shit...

