New onset of Type 1 diabetes mellitus in children and adolescents after COVID-19 infection: A clinical review
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Kandul, E.; Bell, K.; Davis, E. 2022. New onset of Type 1 diabetes mellitus in children and adolescents after COVID-19 infection: A clinical review -- In Proceedings: 18th Annual Symposium on Graduate Research and Scholarly Projects. Wichita, KS: Wichita State University
Diabetes mellitus (DM) and COVID-19 have reciprocal relationships. While diabetic patients have worse prognosis after contracting SARS-CoV-2 virus, the virus itself can cause new-onset diabetes in susceptible individuals. This clinical review describes multiple case reports, research, and epidemiological data demonstrating a link between COVID-19 and new-onset type 1 DM in children and adolescents. There are five proposed mechanisms that explain how COVID-19 can lead to new-onset DM. Pathway 1 induces generic autoimmunity that results in pancreatic betacell destruction. Pathway 2 involves the mis-regulation of the ACE2 and angiotensin II levels, which results in vasoconstriction and decreased blood supply to the pancreas resulting in destruction of the beta-cells and new-onset DM type 1. Pathway 3 explains the effect of cytokines on increased gluconeogenesis and beta-cells destruction. Pathway 4 suggests the correlation between stress and hyperglycemic hormone release, which may lead to metabolic imbalance. Pathway 5 explains how the medications involved in COVID-19 treatment may cause increased blood glucose concentrations triggering new-onset DM in predisposed individuals. The data analyzed in this research suggest an increased risk for new-onset type 1 diabetes in children and adolescents after contracting SARS-CoV-2 virus. It is highly recommended to prevent COVID-19 infection in this population by following CDC guidelines. This clinical review attempts to provide information to medical providers and general public regarding the possible COVID-19 sequelae of diabetes mellitus and DKA as well as importance of long-term monitoring of the patients after either symptomatic or asymptomatic COVID-19 infection.
Presented to the 18th Annual Symposium on Graduate Research and Scholarly Projects (GRASP) held at the Rhatigan Student Center, Wichita State University, April 29, 2022
Research completed in the Department of Physician Assistant, College of Health Professions