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PSUN238 COVID 19 induced Type 1 Diabetes Mellitus
INTRODUCTION: There have been some case reports where patients presented with uncontrolled hyperglycemia without previous diagnosis of diabetes but very limited literature supporting the fact that COVID 19 infection can lead to the development of new onset Type 1 diabetes. CLINICAL CASE: A 30-year-o...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9707324/ http://dx.doi.org/10.1210/jendso/bvac150.805 |
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author | Ahsun, Sana Patamopron, Lekprasert Win, Kay Khine |
author_facet | Ahsun, Sana Patamopron, Lekprasert Win, Kay Khine |
author_sort | Ahsun, Sana |
collection | PubMed |
description | INTRODUCTION: There have been some case reports where patients presented with uncontrolled hyperglycemia without previous diagnosis of diabetes but very limited literature supporting the fact that COVID 19 infection can lead to the development of new onset Type 1 diabetes. CLINICAL CASE: A 30-year-old African American man presented to the office with a diagnosis of new onset DM towards the end of March 2021. He did not have any significant medical history other than prediabetes with a prior HbA1c of 6% and COVID 19 infection in 2020. He had no family history of DM. He was very sick with the COVID 19 infection and lost 20 pounds of weight around that time. He did not get hospitalized and did not have any blood work done. A couple of months after recovery from his COVID 19 illness he developed leg cellulitis. He decided to seek help for this problem and was started on some antibiotics and antifungals, but they did not help much. His leg swelling and pain did not improve so he went to the ER. At that time his work-up showed a HbA1c of 15.5%. Patient was also having polydipsia and polyuria by that time. He was given a new set of antibiotics and was discharged to follow-up with a primary care provider. His PCP started him on Metformin and Lantus insulin for new onset DM2. He was then referred to Endocrinologist for further management. At the time of his endocrine office visit his symptoms of polyuria and polydipsia had improved a lot.His Anti GAD 65 antibodies were positive with a value of 41 (neg <5). C-peptide level was 1.9 which was in the range (1.1-4.4). IAA–2 autoantibodies were positive with a value of more than 120 (neg<7.5). ZNT 8 antibodies and Insulin antibodies were negative. An increase in the number of antibodies is associated with a higher likelihood of type 1 DM. Only less than 3% of type 2 diabetics have positive antibodies. As per the laboratory interpretation our patient had type 1 diabetes. After starting insulin treatment, the HbA1c improved to 6.6% from 15.5%. Patient is currently on continuous glucose monitoring with insulin therapy and has a good glycemic control. CONCLUSION: Our case highlights the importance that SARS-CoV-2 infection is an independent risk factor for the development of new onset type 1 DM and increased risk of complications in preexisting diabetics. There have been studies showing that patients who presented with DKA precipitated by COVID-19 infection had worse outcomes than patient's presenting with DKA without COVID-19 infection. Mortality was higher for COVID-19 in diabetic patients as well. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m. |
format | Online Article Text |
id | pubmed-9707324 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-97073242022-11-30 PSUN238 COVID 19 induced Type 1 Diabetes Mellitus Ahsun, Sana Patamopron, Lekprasert Win, Kay Khine J Endocr Soc Diabetes & Glucose Metabolism INTRODUCTION: There have been some case reports where patients presented with uncontrolled hyperglycemia without previous diagnosis of diabetes but very limited literature supporting the fact that COVID 19 infection can lead to the development of new onset Type 1 diabetes. CLINICAL CASE: A 30-year-old African American man presented to the office with a diagnosis of new onset DM towards the end of March 2021. He did not have any significant medical history other than prediabetes with a prior HbA1c of 6% and COVID 19 infection in 2020. He had no family history of DM. He was very sick with the COVID 19 infection and lost 20 pounds of weight around that time. He did not get hospitalized and did not have any blood work done. A couple of months after recovery from his COVID 19 illness he developed leg cellulitis. He decided to seek help for this problem and was started on some antibiotics and antifungals, but they did not help much. His leg swelling and pain did not improve so he went to the ER. At that time his work-up showed a HbA1c of 15.5%. Patient was also having polydipsia and polyuria by that time. He was given a new set of antibiotics and was discharged to follow-up with a primary care provider. His PCP started him on Metformin and Lantus insulin for new onset DM2. He was then referred to Endocrinologist for further management. At the time of his endocrine office visit his symptoms of polyuria and polydipsia had improved a lot.His Anti GAD 65 antibodies were positive with a value of 41 (neg <5). C-peptide level was 1.9 which was in the range (1.1-4.4). IAA–2 autoantibodies were positive with a value of more than 120 (neg<7.5). ZNT 8 antibodies and Insulin antibodies were negative. An increase in the number of antibodies is associated with a higher likelihood of type 1 DM. Only less than 3% of type 2 diabetics have positive antibodies. As per the laboratory interpretation our patient had type 1 diabetes. After starting insulin treatment, the HbA1c improved to 6.6% from 15.5%. Patient is currently on continuous glucose monitoring with insulin therapy and has a good glycemic control. CONCLUSION: Our case highlights the importance that SARS-CoV-2 infection is an independent risk factor for the development of new onset type 1 DM and increased risk of complications in preexisting diabetics. There have been studies showing that patients who presented with DKA precipitated by COVID-19 infection had worse outcomes than patient's presenting with DKA without COVID-19 infection. Mortality was higher for COVID-19 in diabetic patients as well. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m. Oxford University Press 2022-11-01 /pmc/articles/PMC9707324/ http://dx.doi.org/10.1210/jendso/bvac150.805 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Diabetes & Glucose Metabolism Ahsun, Sana Patamopron, Lekprasert Win, Kay Khine PSUN238 COVID 19 induced Type 1 Diabetes Mellitus |
title | PSUN238 COVID 19 induced Type 1 Diabetes Mellitus |
title_full | PSUN238 COVID 19 induced Type 1 Diabetes Mellitus |
title_fullStr | PSUN238 COVID 19 induced Type 1 Diabetes Mellitus |
title_full_unstemmed | PSUN238 COVID 19 induced Type 1 Diabetes Mellitus |
title_short | PSUN238 COVID 19 induced Type 1 Diabetes Mellitus |
title_sort | psun238 covid 19 induced type 1 diabetes mellitus |
topic | Diabetes & Glucose Metabolism |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9707324/ http://dx.doi.org/10.1210/jendso/bvac150.805 |
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