Endocrine Abstracts

COVID-19 is affecting Northern Italy since early 2020 and long-term consequences of the pandemia are progressively coming to light. Over the past months, a marked increase in the number of adults with rapid-onset severe diabetes has been observed at the Diabetes Clinic thus prompting an evalutation into possible links with COVID-19. Of note, diabetes and hyperglycaemia are known to worsen during COVID-19 and there are several reports of new-onset hyperglycaemia during SARSCoV2 infection, possibly due to the links between SARS-CoV-2 and pancreatic islet damage. Aim of the present study was to review charts of adult patients with newly diagnosed, severe diabetes recorded after the first pandemic wave.

Methods

Data relating to diabetes and SARS-CoV-2 infection was reviewed in patients attending the Diabetes Clinic from September 2020 to March 2021.

Results

Out of 120 patients who attended the clinic in the 7-month span, four (2 men and 2 women, age 51–71 years) presented with recent-onset, severe diabetes. None had previous history for hyperglycaemia or diabetes. Features of uncontrolled hyperglycaemia (e.g., weight loss, glycosuria, polyuria) had developed over the prior 2–3 months; patients were normal-weight or midly overweight and did not report significant changes to their eating habits. HbA1c ranged from 10.7% to 14.1%, fasting glucose from 300 to 410 mg/dl. Testing for autoantibodies common to Type 1 diabetes proved negative. Two patients had previously presented mild symptoms of COVID-19 and tested positive for SARS-Cov-2 whereas the other two reported close contacts with SARS-CoV-2 positive individuals during past months. None of the patients had been hospitalized or required any treatment for COVID-19-related symptoms.

Conclusions

This report describes an increased incidence of rapid-onset, uncontrolled hyperglycaemia in adults with no known risk factor for diabetes in the aftermath of the first COVID-19 pandemic wave. Severe diabetes developed months after mild or asymptomatic SARS-CoV-2 infection and mandates the need for an increased awareness among physicians given the sheer number of individuals who came and will come in contact with SARS-CoV-2.