SARS-CoV-2 Unmasks Type 1 Diabetes Mellitus With an Episode of Diabetic Ketoacidosis

During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, coronavirus disease 2019 (COVID-19) has been significantly studied for its relationship with diabetes mellitus in general. Still, the association of SARS-CoV-2 infection with diabetic ketoacidosis (DKA) is more specific and warrants a meticulous investigational approach. In this case report, we present a 23-year-old female who developed DKA as the first manifestation of SARS-CoV-2 infection. During hospitalization, the diagnosis of type 1 diabetes mellitus (T1DM) was made and the patient was treated successfully for the metabolic disorder and for SARS-CoV-2. The potential of SARS-CoV-2 to induce DKA in type 1 diabetics is highlighted. We point out that DKA and COVID-19 may have similarities in clinical presentation when gastrointestinal features predominate. In addition, we describe mechanisms that have been hypothesized to explain the negative impact of SARS-CoV-2 on the endocrine pancreatic function.