Endocrine Abstracts

Background: Covid 19 infection has previously been reported to be associated with worsening of pre-existing and new onset diabetes mellitus1. However, the association of new onset autoimmune diabetes mellitus after Covid vaccination is not fully recognised in the literature.

History: We report the case of a 58-year-old healthy woman who received a Covid 19 vaccination on 14th of Nov 2021. 2 weeks subsequently she was admitted with headache, blurred vision and visual disturbances and was diagnosed with migraine. Random blood glucose was noted to be 15.3 mmol/l and HbA1c 129 mmol/l confirmed a diagnosis of diabetes mellitus. She had past medical history of Ehlers-Danlos syndrome, factor V Leiden mutation and recurrent venous thromboembolism (VTE) but not diabetes mellitus. HbA1c performed 6 months previously showed a normal result, 37 mmol/l. Her prescribed medications were Warfarin, Quetiapine 300 mg OD, Venlafaxine 75 mg OD and Tapentadol. CT scan of abdomen was done which showed no evidence of any pancreatic abnormalities. Patient was commenced on Metformin and discharged home. Glutamic Acid Decarboxylase, IA-2, and Zinc transporter-8 antibodies were checked and all of them were negative. She was readmitted to hospital 3 months following her initial admission with right leg pain and swelling. On this occasion, HbA1C was 36 mmol/l. Her weight had been steady. Metformin was withdrawn.

Conclusion: It was thought to be a case of DM secondary to some immunological phenomenon after COVID vaccination.

Reference: 1. Xie, Y. & Al-Aly, Z. Lancet Diabetes Endocrinol. https://doi.org/10.1016/S2213-8587(22)00044-4 (2022)