Exploring the causal relationship between COVID-19 and diabetes |  Biospace

Exploring the causal relationship between COVID-19 and diabetes | Biospace

Research is starting to show a normal link between COVID-19 and diabetes. in study Posted in Lancet Diabetes and Endocrinology In March, researchers found that people who suffered from COVID-19 were 40% more likely From controls to eventually develop type 2 diabetes.

Dr. Brian Fertig, MD, founder and president of the Diabetes and Osteoporosis Center in Piscataway, New Jersey, told BioSpace that diabetes risk can be added to the long list of COVID effects.

Presented by Dr. Brian Fertigue Self [square]He said: “In addition to an increased risk of type 2 diabetes by 40% within 12 months, another recent study reported a significant increase in type 1 diabetes 30 days after diagnosis of COVID-19, highlighting the mechanisms of multiple Factors in Physiology”. . Extra study It was released by the Centers for Disease Control and Prevention in January of this year.

Fertig said the insulin deficiency caused by COVID-19 in cases of type 1 diabetes could be related to “a direct devastating effect of the virus on the insulin-producing beta cells of the pancreas.” Another explanation could be that “the protein components of the virus may molecularly mimic beta-cell proteins with destruction mediated by the autoimmune process,” he continued.

As for why COVID-19 increases the risk of type 2 diabetes, Fertig drew parallels with other prolonged COVID symptoms, including “disruption of the sleep/wake cycle and neuropsychological effects that lead to activation of chronically activated autonomic and hormonal branches of the nervous system.” to respond to pressure.

“In this case, the stimulated states of cortisol and adrenaline induce increased glucose production by the liver as well as other antagonistic effects on insulin secretion and its suppressive effects on glucose and lipid levels in the blood,” he explained.

Fertig originally became interested in the growing field of endocrinology during his medical training. Three decades later, I published a two-volume book series, Metabolism and medicinewhich highlights hyperinsulinemia and insulin resistance as a basis for the metabolic decline that occurs with aging, including important links not only to diabetes and obesity but to all chronic diseases, including cardiovascular disease, Alzheimer’s and cancer.

In his personal practice, Fertig shared that some of his patients with “pre-existing diabetes” see their condition getting worse due to COVID-19. “Some (a small minority) of these patients have more aggressive long-term treatment requirements to keep blood sugar and lipid levels in a safe range. Dexamethasone is almost expected to exacerbate glucose levels in patients with known diabetes, often predisposing to prediabetes. In accordance with the study, Fertig also treated patients who developed new cases of type 2 diabetes after COVID-19.

Fertig’s typical recommendation for managing type 2 diabetes includes a low dose of pioglitazone, metformin, and a glucagon-like peptide factor 1 (GLP-1) factor. He said that GLP-1 antagonists aid weight loss, which improves insulin sensitivity and reduces blood sugar levels. “Both pioglitazone (a direct insulin sensitizer) and metformin (an indirect insulin sensitizer) prevent the transformation of adipose fibroblasts into myofibroblasts, and thus have a clear protective effect on complications and mortality associated with COVID-19.”

in Metabolism and medicine Series, Fertig details “a scientific approach to predicting and preventing disease as well as predicting patient responses to therapeutic interventions.” His model, called the Physiological Fitness Landscape (PFL), uses bioinformatics to make these predictions.

When asked what he imagined diabetes treatment would look like a decade from now, he said, “I believe that type 1 diabetes will be cured by injecting insulin-producing beta stem cells into the pancreas that will seed and remain in the liver. Blood glucose levels will likely be higher. It’s normal per se, but low enough to be safe (complication-free) and not require insulin or other treatment interventions.”

With regard to the management of type 2 diabetes, it is expected that a single oral drug with the properties of pioglitazone, metformin and a GLP-1 antagonist will replace the triple therapy approach. “It will potentially be able to modulate the amount of insulin production and fat mass and distribution,” he said, adding that the ideal future drug would be customized according to the guidelines provided in his PFL form.

For both COVID-19 patients and others, Fertig said the best way to reduce diabetes risk is to stick to a “healthy lifestyle that includes nutrient-dense foods, exercise regularly, and quit or reduce bad lifestyle habits.”

He noted that while there are genetic predispositions to diabetes, living under stress, giving up exercise and not prioritizing sleep and diet can be harmful. “A poor micronutrient diet impairs the function of the metabolic machinery and also causes insulin resistance, and thus a predisposition to diabetes.”

The doctor explained, “Insulin resistance and elevated blood insulin levels, found in up to 50% of the adult population in the United States, contribute not only to diabetes but to all of the major chronic diseases of aging including Alzheimer’s and cardiovascular diseases and cancers.” .”

Although type 2 diabetes cannot be cured, Fertig said full and partial recovery is possible. In this case, the patient’s glucose levels return to normal. “Yes, the beta cells have been damaged and the underlying genetic factors remain, but individuals can control the damage by maintaining a healthy weight, an active lifestyle, and a positive mental outlook,” he said.

2022-05-27 04:03:25

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