A Case of Diabetes Mellitus Following the COVID-19 Vaccine

Murat Calapkulu

doi:10.1530/endoabs.90.P646

A Case of Diabetes Mellitus Following the COVID-19 Vaccine

Background: Coronavirus disease-2019 (COVID-19) is a public health issue worldwide. Although COVID-19 vaccines are one of the most effective strategies against COVID-19, it has been reported in recent publications that they can trigger endocrine diseases. Herein, we aimed to present a 37-year-old male patient who had polydipsia, polyuria, thirst, fatigue, and loss of appetite a month after the first dose of the COVID-19 RNA-based vaccine without a prior history of diabetes mellitus.

Case report: A 36-year-old male patient was admitted to the emergency department with complaints of polyuria, polydipsia, thirst, anorexia, and fatigue, which occurred a month after the first dose of the COVID-19 RNA-based vaccine. He had no medical history. Hyperglycemia (645 mg/dl), metabolic acidosis (pH 7.3), and ketonuria were detected in laboratory analysis. The glycated hemoglobin (HbA1c) level was elevated (Table 1). He was diagnosed with diabetic ketoacidosis and management was initiated with intravenous fluid replacement and insulin infusion. When ketoacidosis resolved, subcutaneous multiple daily injections of insulin was initialized. In the follow-up, the patient’s insulin therapy was discontinued, and he was discharged with vildagliptin 100/mg/day and metformin 2000 mg/day treatment. The HbA1c level was 10.4%, and the c-peptide level was 4.04 ng/ml six months after the diagnosis. Pioglitazone 30mg/day was added to the patient’s treatment. The patient’s follow-up continues in our center.

Table 1 Laboratory analysis of patient at the time of admission
	Values	Reference range
Fasting plasma glucose (mg/dl)	645	74-100
HbA1c (%)	18.1	3.5-5.6
Creatinine (mg/dl)	0.75	0.7-1.2
C-reactive protein (mg/l)	1.72	0-5
Sedimentation rate	13	0-20
Sodium (mmol/l)	120	136-146
Potassium (mmol/l)	4.34	3.5-5.1
Calcium (mg/dl)	9.58	8.6-10.2

Conclusions: Recent studies have been reported that COVID-19 vaccination induced hyperglycemia and related complications. In general, the majority of patients presented with common osmotic symptoms of hyperglycemia. In most cases, good glycemic control was attained in patients on oral antidiabetic medication after discharge. As the vaccination of the global population accelerates, there must be an investigation of the side effects of COVID-19 vaccines. So that subjects at risk for diabetes can be predicted and appropriate treatment initiated without severe complications.

Endocrine Abstracts

P646