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Incidence of an Insulin-Requiring Hyperglycemic Syndrome in SARS-CoV-2–Infected Young Individuals: Is It Type 1 Diabetes?

Pancreatic ACE2 receptor expression, together with increased prevalence of insulin-requiring hyperglycemia in patients with coronavirus disease 2019 (COVID-19), suggested that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pancreatic infection might trigger a β-cell–selective inflammat...

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Autores principales: Pietropaolo, Massimo, Hotez, Peter, Giannoukakis, Nick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862279/
https://www.ncbi.nlm.nih.gov/pubmed/35293987
http://dx.doi.org/10.2337/db21-0831
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author Pietropaolo, Massimo
Hotez, Peter
Giannoukakis, Nick
author_facet Pietropaolo, Massimo
Hotez, Peter
Giannoukakis, Nick
author_sort Pietropaolo, Massimo
collection PubMed
description Pancreatic ACE2 receptor expression, together with increased prevalence of insulin-requiring hyperglycemia in patients with coronavirus disease 2019 (COVID-19), suggested that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pancreatic infection might trigger a β-cell–selective inflammation precipitating autoimmune type 1 diabetes (T1D). We examined T1D incidence in patients with COVID-19 inside a large, global population using a “big data” approach. The incidence in 0–30-year-old patients with confirmed COVID-19 over an ∼15-month period from the beginning of the COVID-19 pandemic was compared with an age-matched population without COVID-19 inside the TriNetX COVID-19 Research Network (>80 million deidentified patient electronic medical records globally). The cohorts were used to generate outcomes of T1D postindex. In those up to 18 years of age, the incidence of insulin-requiring diabetes that could represent T1D in patients with already diagnosed, confirmed COVID-19 was statistically indistinguishable from the control population without COVID-19. In contrast, in those aged 19–30 years, the incidence was statistically greater. These data suggest that the incidence of T1D among patients with COVID-19 <30 years of age, at least up to this time since the beginning of the pandemic, is not greater when compared with an age-, sex-, and BMI-matched population without COVID-19. Nevertheless, we caution that patients with COVID-19 could be asymptomatic of a diabetic/prediabetic state and therefore would not be expected to come to medical attention, remaining undiagnosed. Hence, it is still possible that asymptomatic virus-infected individuals could acquire β-cell autoimmunity, eventually progressing to dysglycemia and clinical T1D at higher rates.
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spelling pubmed-98622792023-02-03 Incidence of an Insulin-Requiring Hyperglycemic Syndrome in SARS-CoV-2–Infected Young Individuals: Is It Type 1 Diabetes? Pietropaolo, Massimo Hotez, Peter Giannoukakis, Nick Diabetes Pathophysiology Pancreatic ACE2 receptor expression, together with increased prevalence of insulin-requiring hyperglycemia in patients with coronavirus disease 2019 (COVID-19), suggested that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pancreatic infection might trigger a β-cell–selective inflammation precipitating autoimmune type 1 diabetes (T1D). We examined T1D incidence in patients with COVID-19 inside a large, global population using a “big data” approach. The incidence in 0–30-year-old patients with confirmed COVID-19 over an ∼15-month period from the beginning of the COVID-19 pandemic was compared with an age-matched population without COVID-19 inside the TriNetX COVID-19 Research Network (>80 million deidentified patient electronic medical records globally). The cohorts were used to generate outcomes of T1D postindex. In those up to 18 years of age, the incidence of insulin-requiring diabetes that could represent T1D in patients with already diagnosed, confirmed COVID-19 was statistically indistinguishable from the control population without COVID-19. In contrast, in those aged 19–30 years, the incidence was statistically greater. These data suggest that the incidence of T1D among patients with COVID-19 <30 years of age, at least up to this time since the beginning of the pandemic, is not greater when compared with an age-, sex-, and BMI-matched population without COVID-19. Nevertheless, we caution that patients with COVID-19 could be asymptomatic of a diabetic/prediabetic state and therefore would not be expected to come to medical attention, remaining undiagnosed. Hence, it is still possible that asymptomatic virus-infected individuals could acquire β-cell autoimmunity, eventually progressing to dysglycemia and clinical T1D at higher rates. American Diabetes Association 2022-12 2022-03-16 /pmc/articles/PMC9862279/ /pubmed/35293987 http://dx.doi.org/10.2337/db21-0831 Text en © 2022 by the American Diabetes Association https://www.diabetesjournals.org/journals/pages/licenseReaders may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at https://www.diabetesjournals.org/journals/pages/license.
spellingShingle Pathophysiology
Pietropaolo, Massimo
Hotez, Peter
Giannoukakis, Nick
Incidence of an Insulin-Requiring Hyperglycemic Syndrome in SARS-CoV-2–Infected Young Individuals: Is It Type 1 Diabetes?
title Incidence of an Insulin-Requiring Hyperglycemic Syndrome in SARS-CoV-2–Infected Young Individuals: Is It Type 1 Diabetes?
title_full Incidence of an Insulin-Requiring Hyperglycemic Syndrome in SARS-CoV-2–Infected Young Individuals: Is It Type 1 Diabetes?
title_fullStr Incidence of an Insulin-Requiring Hyperglycemic Syndrome in SARS-CoV-2–Infected Young Individuals: Is It Type 1 Diabetes?
title_full_unstemmed Incidence of an Insulin-Requiring Hyperglycemic Syndrome in SARS-CoV-2–Infected Young Individuals: Is It Type 1 Diabetes?
title_short Incidence of an Insulin-Requiring Hyperglycemic Syndrome in SARS-CoV-2–Infected Young Individuals: Is It Type 1 Diabetes?
title_sort incidence of an insulin-requiring hyperglycemic syndrome in sars-cov-2–infected young individuals: is it type 1 diabetes?
topic Pathophysiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862279/
https://www.ncbi.nlm.nih.gov/pubmed/35293987
http://dx.doi.org/10.2337/db21-0831
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