New onset diabetes mellitus in post-COVID-19 patients

B Y Keerthi; G Sushmita; Ehsan A Khan; Vimala Thomas; Vikram Cheryala; Chirali Shah; G Ravi Kumar; V Haritha

doi:10.4103/jfmpc.jfmpc_316_22

New onset diabetes mellitus in post-COVID-19 patients

J Family Med Prim Care. 2022 Oct;11(10):5961-5968. doi: 10.4103/jfmpc.jfmpc_316_22. Epub 2022 Oct 31.

Authors

B Y Keerthi¹, G Sushmita¹, Ehsan A Khan¹, Vimala Thomas², Vikram Cheryala³, Chirali Shah⁴, G Ravi Kumar⁵, V Haritha⁶

Affiliations

¹ Department of General Medicine, Telangana Institute of Medical Sciences and Research, Gachibowli, Telangana, India.
² Department of Social and Preventive Medicine, Telangana Institute of Medical Sciences and Research, Gachibowli, Telangana, India.
³ Department of Family Medicine, Telangana Institute of Medical Sciences and Research, Gachibowli, Telangana, India.
⁴ Department of Pulmonary Medicine, Telangana Institute of Medical Sciences and Research, Gachibowli, Telangana, India.
⁵ Department of Biochemistry, Telangana Institute of Medical Sciences and Research, Gachibowli, Telangana, India.
⁶ Department of Microbiology, Telangana Institute of Medical Sciences and Research, Gachibowli, Telangana, India.

Abstract

Background: Diabetes, is known to have a bilateral relationship with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Precise mechanism of diabetes onset in COVID-19 patients remains unclear.

Aim: To analyse the incidence of new onset diabetes (NODM) among COVID-19 patients, as well as the effect of body mass index (BMI), family history, and steroid use on the incidence of the disease.

Methods: Adult, not known diabetic patients, tested positive with Rapid Antigen Test or RT-PCR admitted to a tertiary care hospital and research institute were included in the present prospective observational study. The patients who developed NODM and NOPD (New Onset Pre-diabetes) during the three months follow-up and the risk factors associated were assessed. Patients with HbA1c >6.4% were diagnosed with NODM. An HbA1c of 5.7% to 6.4% was used to characterize NOPD.

Results: Out of 273 previously not known diabetic COVID-19 infected individuals, a total of 100 were studied for three months after consent. Mean age of the patients 48.31 ± 19.07 years with male predominance (67%). Among these, 58% were non-diabetics and 42% were pre-diabetics. 6 (10.3%) of the 58 non-diabetics developed NOPD, and 8 (13.8%) developed NODM. 6 (14.2%) of the 42 pre-diabetics became non-diabetic, and 16.6% (7) developed NODM. Family history of DM (P < 0.001), severity at admission (P < 0.006), diabetic ketoacidosis (P < 0.0275), and persistent symptoms were associated significantly with NODM. Those with NODM had significantly greater BMI, O₂ duration, steroid duration, FBS, and PPBS (P < 0.001 for all). Nearly 67% of the patients who developed NOPD had shortness of breath as the common symptom at time of admission (P = 0.0165).

Conclusion: The incidence of NODM was strongly influenced by positive family history of DM, higher BMI, steroid dosage, and its duration. Hence, patients with COVID-19 need to be under surveillance for blood glucose screening.

Keywords: BMI; HbA1c; NODM; NOPD; SARS-CoV-2; family history of DM; steroids.