Throwing together some advocacy discussion fodder more publicly here, as requested:
There have been reports of type 1 diabetes onset status post COVID-19 infection, as well as diabetic ketoacidosis (DKA) and insulin resistance being related threats when it comes to COVID-19 treatment. While I’d be remiss not to mention the main grad school 101 lesson, “Correlation doesn’t equal causation,” (meaning that we do not know for sure that COVID-19 may or may not cause or complicate diabetes yet), we can still take commonsensical precautions in the interim to prevent further possible suffering. I will be the first to admit that I’m not going to do your homework for you here and link to various articles and tweet threads on these topics; they’re out there if interested, and I’m writing this blog as a highly-generalized, well-intentioned commentary with the disclaimer that we do not have all of the answers yet and the advice here is shared in an abundance of caution and transparent discourse.
We need more research data and more analyses of these theories, plain and simple. ‘Awareness’ is often a diluted catch phrase in healthcare advocacy, but in this instance, knowing what may happen – while we iron out the scientific facts of the matter – could possibly save lives and quality of lives. For these reasons, I don’t think relaying the message hurts us, with the understanding that more research must occur.
The prevalent theory on the cause of type 1 diabetes (T1D), an autoimmune condition, is that the perfect storm of factors – viral trigger, genetic predisposition, and environment (often stressor-related)- culminates in a diagnosis- that is if one survives the common DKA at onset and is swiftly treated with insulin. Time is of the essence, life or death, here.
Theoretically, COVID-19 plays into this theory perfectly, being the viral trigger that gets the ball rolling in some cases of T1D, with the person’s immune system having been sent into overdrive by the infection. Healthcare professionals have reported that COVID-19 does not play well with pancreatic function, often requiring highly elevated basal insulin rates and thwarting DKA in the process of treating COVID. None of this sounds remotely fun and should be impetus to us all to do our part to protect ourselves and others.
If you’ve contracted COVID-19 recently, in my humble opinion it is wise to be aware of the warning signs of type 1 diabetes given a qualitatively potential risk post-Covid-infection. There are fancy posters and awareness campaigns which display this information in a prettier way than this blog post, but for what it’s worth, the main symptoms of T1D which I advise others to watch for are the following, among others:
Fruity breath / odor
Significant weight loss
Ketones may present a heartburn-like sensation.
If any of these symptoms are present, contact a healthcare professional (HCP) / emergency room immediately, and demand to be tested for T1D. If HCPs are downplaying the odds, and if you can afford this option, purchase a blood glucose meter and test strips, or urine ketone strips, over the counter at your local pharmacy and check on your own. If results are elevated, this bolsters your point that you need to be seen immediately regarding a possible diabetes diagnosis.
The anecdotal evidence is quite strong that we may face an influx of diabetes in the era of COVID-19. We might as well start talking about it.
One thought on “T1D in the COVID-19 Era”
As you suggest, I have long believed that T1D is, a genetic predisposition and an environmental trigger c9mbined into a perfect storm of ugliness that results in T1D. I know I had one (genetics) and likely another (stress). But who knows for sure.
Is COVID-19 a trigger? I’ve no idea. Could it be? Yes, why not. I suspect it could be anything. COVID-19 is as good as any and maybe better than all others. If there is room in the discussion, add me in.