Type 1 diabetes onset triggered by COVID-19
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SHORT COMMUNICATION
Type 1 diabetes onset triggered by COVID‑19 Lucien Marchand1 · Matthieu Pecquet2 · Cédric Luyton1 Received: 1 June 2020 / Accepted: 1 July 2020 © Springer-Verlag Italia S.r.l., part of Springer Nature 2020
The epidemic of coronavirus disease-2019 (COVID-19) is caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus. Some data describing characteristics and prognosis of patients with COVID-19 and diabetes are now available, for example, for hospitalized patients in the CORONADO study [1]. Potential links between diabetes and COVID-19 infection were already described [2]. Indeed, angiotensin-converting enzyme 2 (ACE2) has been identified as the receptor for the coronavirus spike protein [3], and ACE is expressed on pancreatic beta cells [2]. It was suggested that SARS-CoV2 could induce beta cell damage and new onset diabetes [2], but the phenotype of these new cases of diabetes has not been described. Here we report the case of a 29-year-old woman with a medical history of gastric by-pass one year earlier and family history of diabetes (aunts with type 2 diabetes; a cousin with type 1 diabetes diagnosed at the age of 7 years). She presented two months earlier (20 March 2020) severe asthenia, fever, stiffness and dyspnea. Then, she presented anosmia and ageusia, with anorexia (25 march). She was admitted at the emergency department, symptomatic treatment was delivered for a suspected COVID-19 infection, and she was discharged (glycemia was normal at this time). Two weeks after, she did no longer have any symptoms. But one month after her first symptoms of COVID-19 (24 April), she presented acute polyuria–polydipsia syndrome. Diabetes mellitus was diagnosed (12 may) with a glycemia of 3.7 g/l (20.5 mmol/l), non-significant ketosis (0.7 mmol/l) and normal bicarbonate level (26 mmol/l). HbA1c level was 11.8% (105 mmol/mol). Her weight was 120 kg before Managed by Antonio Secchi. * Lucien Marchand lmarchand@ch‑stjoseph‑stluc‑lyon.fr 1
Department of Endocrinology and Diabetes, Centre Hospitalier Saint Joseph Saint Luc, Quai Claude Bernard, 69007 Lyon, France
Department of Biology, Centre Hospitalier Saint Joseph Saint Luc, Lyon, France
2
gastric by-pass, 65 kg before COVID-19 and 57 kg (BMI of 21.5 kg/m2) at diabetes diagnosis. The diabetes was immediately insulin requiring, and she was treated with basal bolus regimen. She did not present metabolic comorbidities and markers (no hypertension, negative CRP (
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