A global registry of new cases of diabetes in patients with Covid-19 has been created after emerging evidence suggests that the virus may actually trigger the onset of diabetes in healthy people.

A letter published in the New England Journal of Medicine and signed by an international group of 17 leading diabetes experts announces the establishment of the CoviDiab Registry project, a collaborative international research initiative.

The Registry aims to understand the extent and the characteristics of the manifestations of diabetes in patients with Covid-19, and the best strategies for the treatment and monitoring of affected patients, during and after the pandemic.

New-onset diabetes has been observed in Covid-19 patients

Clinical observations so far show a bi-directional relationship between Covid-19 and diabetes. On the one hand, diabetes is associated with increased risk of Covid-19 severity and mortality. Between 20 and 30% of patients who died with Covid-19 have been reported to have diabetes. On the other hand, new-onset diabetes and atypical metabolic complications of pre-existing diabetes, including life-threatening ones, have been observed in people with Covid-19.

Research shows that coronavirus is not only located in the lungs but also in organs and tissues involved in glucose metabolism such as the pancreas, the small intestine, the fat tissue, the liver and the kidney. Researchers hypothesise that by entering these tissues, the virus may cause multiple and complex dysfunctions of glucose metabolism. It has also been known for many years that virus infections can precipitate type 1 diabetes.

Francesco Rubino, Professor of Metabolic Surgery at King's College London and co-lead investigator of the CoviDiab Registry project, said: "Diabetes is one of the most prevalent chronic diseases and we are now realising the consequences of the inevitable clash between two pandemics.

"Given the short period of human contact with this new coronavirus, the exact mechanism by which the virus influences glucose metabolism is still unclear and we don't know whether the acute manifestation of diabetes in these patients represent classic type 1, type 2 or possibly a new form of diabetes."

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