COVID-19 May Increase the Risk of Insulin Resistance in Adult Patients Without Diabetes: A 6-Month Prospective Study

Chen, Mochuan; Zhu, Bing; Chen, Dong; Hu, Xianluo; Xu, Xueqin; Shen, Wen‐Jun; Hu, Chenchan; Li, Jue; Qu, Shen

doi:10.1016/j.eprac.2021.04.004

Cited by 46 publications

(48 citation statements)

References 49 publications

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“…Thus, it is plausible that COVID-19 could create a perturbation in the glycometabolic complex system with resulting hyperglycemia and insulin resistance that can not only complicate the pathophysiology of pre-existing diabetes but also may lead to new-onset diabetes. Very recent studies showed that aberrant glycometabolic control and aggravated insulin resistant in COVID-19 patients without pre-existing diabetes persisted for at least 6 months after the infection [ 11 , 12 ]. Whether elevated glucose concentrations (in a non-diabetes range) or new-onset diabetes, is likely to remain permanent is not known at the present time.…”

Section: Discussionmentioning

confidence: 99%

“…The SARS-CoV-2-induced down-regulation of ACE2 and the resulting increased Ang II may be a critical promoter of observed insulin resistance in COVID-19 [ 11 , 12 ] because increased levels of Ang II has been associated with deterioration of β-cell function [ 21 ]. In fact, in vivo studies showed that Ang II disrupts insulin-stimulated IRS-1/IRS-2-associated PI3-kinase pathway activities, thereby impairing GLUT-4 translocation into membrane of insulin-sensitive tissues such as muscle, liver and adipose tissue [ 22 , 23 ].…”

Section: Viral Entrance (Lateral Face 1)mentioning

confidence: 99%

“…These findings demonstrate that SARS-CoV-2 induces an insulin resistance state per se leading to aberrant glycometabolic control, which can persist in the patients who recovered from COVID-19. In another 6-month prospective study, it was shown that SARS-CoV-2 induced the risk of insulin resistance in patients without prior history of diabetes, which persisted at both 3-month and 6-month post COVID-19 phases [ 12 ]. Therefore, SARS-CoV-2 may induce and aggravate an insulin resistance state based on a proinflammatory milieu, resembling that which could be seen in patients with type 2 diabetes mellitus.…”

Section: Inflammation (Lateral Face 3) and Insulin Resistance (Lateral Face 4)mentioning

confidence: 99%

“…Although several lines of evidence suggest that the interaction between ACE2, ADAM17, and TMPRSS2 is pivotal for SARS-CoV-2 related pancreatic β cells injury [ 10 ], data on the pancreatic β cells pathologic alterations and the resulting long-term changes remain inconclusive. However, more recent studies showed that the systemic proinflammatory milieu following the COVID-19 cytokine storm may play a major role in insulin resistance, beta cell hyperstimulation and disruption of insulin signaling, eventually leading to SARS-CoV-2- induced DM [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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The COVID-19-diabetes mellitus molecular tetrahedron

et al. 2022

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Accumulating molecular evidence suggests that insulin resistance, rather than SARS-CoV-2- provoked beta-cell impairment, plays a major role in the observed rapid metabolic deterioration in diabetes, or new-onset hyperglycemia, during the COVID-19 clinical course. In order to clarify the underlying complexity of COVID-19 and diabetes mellitus interactions, we propose the imaginary diabetes-COVID-19 molecular tetrahedron with four lateral faces consisting of SARS-CoV-2 entry via ACE2 (lateral face 1), the viral hijacking and replication (lateral face 2), acute inflammatory responses (lateral face 3), and the resulting insulin resistance (lateral face 4). The entrance of SARS-CoV-2 using ACE2 receptor triggers an array of multiple molecular signaling beyond that of the angiotensin II/ACE2-Ang-(1–7) axis, such as down-regulation of PGC-1 α/irisin, increased SREBP-1c activity, upregulation of CD36 and Sirt1 inhibition leading to insulin resistance. In another arm of the molecular cascade, the SARS-CoV-2 hijacking and replication induces a series of molecular events in the host cell metabolic machinery, including upregulation of SREBP-2, decrement in Sirt1 expression, dysregulation in PPAR-ɣ, and LPI resulting in insulin resistance. The COVID-19-diabetes molecular tetrahedron may suggest novel targets for therapeutic interventions to overcome insulin resistance that underlies the pathophysiology of worsening metabolic control in patients with diabetes mellitus or the new-onset of hyperglycemia in COVID-19.

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Section: Discussionmentioning

confidence: 99%

Section: Viral Entrance (Lateral Face 1)mentioning

confidence: 99%

Section: Inflammation (Lateral Face 3) and Insulin Resistance (Lateral Face 4)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The COVID-19-diabetes mellitus molecular tetrahedron

et al. 2022

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“…However, researchers could not eliminate BMI influencing carbohydrate metabolism, since the average BMI was higher than recommended. [64].…”

Section: Diabetesmentioning

confidence: 99%

Excess Body Mass—A Factor Leading to the Deterioration of COVID-19 and Its Complications—A Narrative Review

Gryczyńska

Litvinov

Bitew

et al. 2021

Viruses

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Currently, the world is facing two serious pandemics: obesity and COVID-19. It is well-established that the prevalence of obesity has risen dramatically, causing a deterioration in the health quality of the population and increasing susceptibility for the unfavourable course of acute infections. It has been observed that excess body mass significantly influences the COVID-19 outcome. The aim of this review is to present the latest scientific reports on the impact of excess body mass on the course and complications of COVID-19. The Web of Science, PubMed, and Google Scholar databases were searched. Only studies reporting patients stated to be COVID-19 positive based on the results of a nasopharyngeal swab and the ribonucleic acid test were included. It is shown that thromboembolic and ischemic complications, namely stroke, disseminated intravascular coagulation, severe hyperglycaemia, and leukoencephalopathy are more likely to appear in COVID-19 positive patients with obesity compared to non-obese subjects. COVID-19 complications such as cardiomyopathy, dysrhythmias, endothelial dysfunction, acute kidney injury, dyslipidaemia, lung lesions and acute respiratory distress syndrome have a worse outcome among obese patients.

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Type 1 diabetes: A new vision of the disease based on endotypes

Weston,

Boehm,

Pozzilli

2024

Diabetes Metabolism Res

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Diagnosis and management of type 1 diabetes (T1D) have remained largely unchanged for the last several years. The management of the disease remains primarily focused on its phenotypical presentation and less on endotypes, namely the specific biological mechanisms behind the development of the disease. Furthermore, the treatment of T1D is essentially universal and indiscriminate—with patients administering insulin at varying dosages and frequencies to maintain adequate glycaemic control. However, it is now well understood that T1D is a heterogeneous disease with many different biological mechanisms (i.e. endotypes) behind its complex pathophysiology. A range of factors, including age of onset, immune system regulation, rate of β‐cell destruction, autoantibodies, body weight, genetics and the exposome are recognised to play a role in the development of the condition. Patients can be classified into distinct diabetic subtypes based on these factors, which can be used to categorise patients into specific endotypes. The classification of patients into endotypes allows for a greater understanding of the natural progression of the disease, giving rise to more accurate and patient‐centred therapies and follow‐up monitoring, specifically for other autoimmune diseases. This review proposes 6 unique endotypes of T1D based on the current literature. The recognition of these endotypes could then be used to direct therapeutic modalities based on patients' individual pathophysiology.

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COVID-19 May Increase the Risk of Insulin Resistance in Adult Patients Without Diabetes: A 6-Month Prospective Study

Cited by 46 publications

References 49 publications

The COVID-19-diabetes mellitus molecular tetrahedron

The COVID-19-diabetes mellitus molecular tetrahedron

Excess Body Mass—A Factor Leading to the Deterioration of COVID-19 and Its Complications—A Narrative Review

Type 1 diabetes: A new vision of the disease based on endotypes

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