Rachael is a freelance healthcare writer and critical care nurse based near Cleveland, Ohio.
Studies show that people who have recovered from COVID-19 are at a greater risk of developing type 2 diabetes.
Researchers are still trying to understand how and why this might be. Here is what is known and what you can do to reduce your risk.
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SARS-CoV-2, the virus that causes the COVID-19 infection, has been linked to all sorts of long-term health issues—even after mild cases of infection.
Roughly 1 in 13 American adults have reported ongoing symptoms even after their initial COVID-19 infection has resolved. According to the Centers for Disease Control and Prevention (CDC), these “long COVID” symptoms are ones that last for one to three months or more after infection that you didn’t have before being infected with the virus.
Symptoms of long COVID are most prevalent in certain groups of people, such as in older populations or people with other chronic illnesses. However, these symptoms have been found both in people hospitalized with severe COVID-19 and those who had only mild infections.
The most common long COVID symptoms are:
While these are the most common symptoms, there have also been other complications that appear after a COVID-19 infection. People with diabetes have reported increased issues with blood sugar control and other diabetes symptoms after COVID-19, but studies show that even people who didn’t have diabetes before are developing the condition in the months after even a mild COVID-19 infection.
One study from the American Diabetes Association (ADA) estimates that people with diabetes are up to 4 times more likely to develop post-COVID infection symptoms or complications (long COVID) than people without diabetes. This research is ongoing, however, and continues to be further studied.
Researchers are still trying to determine the exact link between COVID-19 and diabetes, but the leading theory is based on the virus’s effect on angiotensin-converting enzyme 2 (ACE2) receptors.
ACE2 is an enzyme, as well as a receptor found on the surfaces of cells. These receptors are highly concentrated in the heart, kidneys, and lungs. They are also where the coronavirus enters cells.
The SARS-CoV-2 virus is thought to have a particularly destructive effect on ACE2 receptor cells in the pancreas—the organ that produces insulin and plays the most significant role in diabetes development.
Although some of the new diagnoses of diabetes after COVID-19 are in people who were considered prediabetic (having high blood sugar levels that are not high enough to qualify as diabetes) before the virus, there is also evidence that spikes in blood sugar from the body’s stress response to COVID-19 also play a role.
As the body fights the virus, it produces a cytokine storm (a rush of specific immune cells)—a reaction that increases blood sugar levels. Certain medications used to treat COVID-19, like steroids, can also contribute to increased blood sugar. Still, the CDC estimates that less than 2.5% of new diabetes cases after COVID-19 were related to medications or chemicals used to treat COVID-19.
Researchers are also investigating whether some of the same comorbidities (co-occurring conditions) that increase the risk of developing a COVID-19 infection are responsible for this bump in new diabetes diagnoses after infection. These comorbidities include obesity and an increased body mass index (BMI).
It will take time to determine whether diabetes that appears after a COVID-19 infection is a permanent or temporary condition. How long blood glucose changes or diabetes last after a COVID-19 infection can vary from person to person based on their health before and after COVID-19.
Some studies, however, have found that only about 40% of people who developed post-COVID diabetes were still considered diabetic at follow-up appointments.
Type 2 diabetes is generally treated the same regardless of its cause. The main goals of diabetes treatment are to control and monitor:
Diet and lifestyle modifications can help prevent diabetic complications or severe diabetes when started early. In more advanced stages of diabetes, oral medications or injected insulin may be required to manage your diabetes and prevent long-term complications.
Some of the measures you may need to take to treat type 2 diabetes include:
Maintaining a healthy diet and active lifestyle can help prevent type 2 diabetes.
Diabetes that develops after COVID-19 can't always be prevented. If the virus triggers cellular changes that lead to diabetes, it may be out of your control. You can take steps, however, to optimize your health through a healthy diet and exercise. It also helps to prevent your chances of being infected by:
Some researchers also suggest increasing screening for complications like diabetes, even after a mild COVID-19 illness.
Not everyone who develops diabetes after a COVID-19 infection will have diabetes forever. Several studies have found that the prevalence of new-onset diabetes after COVID-19 drops in the months after the initial infection. However, research also suggests that mortality rates are higher in people who develop new diabetes during COVID-19 than in those who had diabetes prior to their illness.
Whether your diabetes is temporary or permanent after COVID-19, controlling your blood glucose and maintaining an overall healthy lifestyle is important to avoid serious complications like kidney disease, eye disease, nerve damage, or cardiovascular issues.
Several serious, long-term consequences have been associated with a COVID-19 illness. Common long COVID symptoms include fatigue, persistent cough, and difficulty concentrating, but new-onset diabetes may also occur after COVID-19 infections. Not all cases of post-COVID diabetes are permanent, but more research is needed to understand how post-COVID diabetes develops, who is most at risk, and how it can best be prevented or treated.
If you have persistent or new health concerns after COVID-19, talk to your healthcare provider about screening you for post-COVID complications.
If you were considered prediabetic before your COVID-19 infection, or if you develop new health problems after COVID-19, talk to your healthcare provider about screening you for new-onset diabetes and other post-COVID complications.
Vaccines developed to help prevent COVID-19 infections can cause increases in blood sugar levels, but these increases are usually only temporary. More research is needed to understand the exact cause and long-term effect of blood sugar increases related to COVID-19 vaccinations.
No, not all cases of diabetes that develop after a COVID-19 infection appear to be permanent. More research is needed to understand who develops permanent diabetes after COVID-19 and why.
Many long-term symptoms or complications can arise after COVID-19 infections. Fatigue and respiratory symptoms, like cough, are most common, but new-onset diabetes has also developed in some people after even mild infections.
Centers for Disease Control and Prevention. Nearly one in five american adults who have had COVID-19 still have “long COVID.”
Centers for Disease Control and Prevention. Long COVID or post-COVID conditions.
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Xie Y, Al-Aly Z. Risks and burdens of incident diabetes in long COVID: a cohort study. Lancet Diabetes Endocrinol. 2022;10(5):311-321. doi:10.1016/S2213-8587(22)00044-4
American Diabetes Association. Individuals with diabetes are up to four times more likely to develop long COVID-19.
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Khunti K, Del Prato S, Mathieu C, et al. COVID-19, hyperglycemia, and new-onset diabetes. Diabetes Care. 2021;44(12):2645-2655. doi:10.2337/dc21-1318
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Rachael is a freelance healthcare writer and critical care nurse based near Cleveland, Ohio.
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