It is quite clear by now that COVID-19, the infection caused by the novel coronavirus, causes severe illness in people with pre-existing health conditions, such as high blood pressure, heart disease, lung illness, and diabetes.

Now, a team of researchers has warned that the infection may trigger the development of diabetes in healthy people, noting there is a bidirectional association between COVID-19 and diabetes.

Diabetics are at greater risk of contracting the new coronavirus. However, the researchers have now found that some healthy people who contracted the virus have developed new-onset diabetes.

Studies have shown that diabetics are more likely to die from COVID-19 infection. But, a new piece of evidence has found that the association goes both ways – being infected with COVID-19 significantly increases one’s risk of developing new-onset diabetes.

However, the exact relationship between the new-onset of diabetes and COVID-19 is still unclear, but experts believe that it could be tied to how the coronavirus adheres to the cells in the body.

The virus adheres to angiotensin-converting enzyme 2 (ACE2) receptors that play an important role in metabolic organs and tissues, such as the beta cells of the pancreases, the small intestines, adipose tissues, and the kidneys.

Therefore, it is possible that the infection could affect the pancreatic beta cells that secrete insulin, a hormone that regulates blood sugar.

“Thus, it is plausible that SARS-CoV-2 may cause pleiotropic alterations of glucose metabolism that could complicate the pathophysiology of preexisting diabetes or lead to new mechanisms of disease,” the researchers wrote in a letter published The New England Journal of Medicine.

They also noted that some people who were affected by the SARS-Cov-1, which first emerged in 2002-2003, also developed acute diabetes during the outbreak.

The team that participated in the CoviDIAB Project has generated a global registry of COVID-19 patients with diabetes, which aims to establish the extent of new-onset diabetes.

They wrote, “The registry, which will be expanded to include patients with preexisting diabetes who present with severe acute metabolic disturbance, may also be used to investigate the epidemiologic features and pathogenesis of COVID-19–related diabetes and to gain clues regarding appropriate care for patients during and after the course of COVID-19.”

The authors said more studies are required to better understand what is actually going on between COVID-19 and diabetes.

Meanwhile, they cautioned COVID-19 patients to watch out for diabetes symptoms such as increased appetite, increased thirst, increased urination, extreme fatigue, confusion, and blurred vision. “Given the very short history of human infection with SARS-CoV-2, an understanding of how COVID-19–related diabetes develops, the natural history of this disease, and appropriate management will be helpful,” the team added. “The study of COVID-19–related diabetes may also uncover novel mechanisms of disease.”