Novel appearance of hyperglycemia/diabetes, associated with COVID-19

Ioannis Ilias

Ioannis Ilias, Department of Endocrinology, Diabetes & Metabolism, Elena Venizelou Hospital,Athens GR-11521, Greece

Abstract In a recent meta-analysis the prevalence of coronavirus disease 2019 (COVID-19)-associated hyperglycemia was 25%, and that of COVID-19-associated new-onset diabetes was 19%. An association between hyperglycemia or new-onset diabetes and COVID-19 has been suggested. In a recent relevant study of critically and non-critically ill patients with COVID-19, we found that indeed beta-cell function was compromised in critically ill patients with COVID-19 and that these patients showed a high glycemic gap. Nevertheless, one quarter of critically ill patients with no history of diabetes have stress hyperglycemia, a finding which could obscure the prevalence of hyperglycemia or new-onset diabetes that could be attributed to COVID-19 per se.

Key Words: Blood glucose; Pandemics; Severe acute respiratory syndrome coronavirus 2;Humans; Hyperglycemia; Hospitalization

TO THE EDITOR

We have read with great interest the work by Shresthaet al[1] regarding new-onset hyperglycemia/ diabetes (DM) in patients with coronavirus disease 2019 (COVID-19). With an erudite meta-analysis the authors found that the pooled prevalence of COVID-19-associated hyperglycemia was 25.23% and that the prevalence of COVID-19-associated new-onset DM was 19.70%[1].

An association between hyperglycemia/new-onset DM and COVID-19 has been suggested[2],viadecreased insulin secretion and increased insulin resistance[2,3]. In a recent relevant study, of critically and non-critically ill patients with COVID-19, we found that indeed beta cell function (based on glucose and insulin measurements and using the Homeostasis Model Assessment HOMA2 estimate of steady state beta cell function[4]) was compromised in critically ill patients with COVID-19. Furthermore, these patients showed a high glycemic gap (based on admission glucose and glycated hemoglobin measurements)[5]. Nevertheless, we acknowledged that on average, 25% of critically ill patients with no history of DM have stress hyperglycemia[5-7], a finding which could obscure the prevalence of hyperglycemia/new-onset DM that could be attributed to COVID-19per se.

Thus, it would be interesting if the results of the study by Shresthaet al[1] were presented separatelyif possible-for critically and non-critically ill patients with COVID-19 and compared to non-COVID-19 patients.

FOOTNOTES

Author contributions:Ilias I conceived and wrote this letter.

Conflict-of-interest statement:The author declares no conflict of interest.

Open-Access:This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BYNC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is noncommercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Country/Territory of origin:Greece

ORCID number:Ioannis Ilias 0000-0001-5718-7441.

S-Editor:Fan JR

L-Editor:A

P-Editor:Fan JR