Higher risk of diabetes among Covid’s long-term effects

Covid-19 can affect an individual’s beta cells found in the pancreas that produce insulin, says the report.

Ben O. de Vera, Kathleen de Villa

Ben O. de Vera, Kathleen de Villa

Philippine Daily Inquirer


March 31, 2022

MANILA — People who contracted COVID-19 may be at a higher risk of developing diabetes as a long-term effect of the coronavirus.

According to Dr. Aurora Macaballug of the Philippine Society of Endocrinology, Diabetes and Metabolism, COVID-19 can affect an individual’s beta cells found in the pancreas that produce insulin, which is the hormone that regulates the level of glucose, a type of sugar, in the blood.

“It can affect the beta cells… and that could be the pathway. There are theories on that,” Macaballug told reporters in an online briefing on Wednesday.

US study
Patients who were given steroids for the management and treatment of COVID-19 should also be monitored as steroids could cause a spike in blood sugar, she added.

“There is what we call a steroid-induced or stress-induced hyperglycemia and it may challenge our [body’s] system. The body may not be able to cope well due to the increase in blood sugar, eventually leading to diabetes,” said Macaballug, who is both an internist and an endocrinologist.

A study published last week in the medical journal The Lancet found “an increased risk and 12-month burdens” of incident diabetes in people with COVID-19 than in those without. Covering more than 180,000 individuals in the United States from March 2020 to September 2021, the study suggested that post-COVID-19 care should involve the identification and management of diabetes.

A local study, titled “The outcomes of patients with diabetes mellitus in the Philippine CORONA Study” and published in 2021, found that one in five Filipinos who contracted COVID-19 had diabetes. Of those with COVID-19 and diabetes, 30 percent had respiratory failure, 34 percent ended up in the intensive care unit and 53 percent died.

But Macaballug said that as long as blood glucose was “well controlled” at a range of 70 to 180 milligrams/deciliter (mg/dL), mortality was low at about 11 percent and survival was at 99 percent.

It is important for people with diabetes to get booster shots as elevated HbA1c, or the three-month average blood sugar, lowers vaccine effectiveness, she said.

There are about four million Filipinos diagnosed with diabetes, according to the International Diabetes Federation.

Macaballug cited a 2021 study that found the effectiveness of COVID-19 jabs “declined mildly but significantly with age and for patients with specific chronic comorbidities, most notably type 2 diabetes.”

Based on the latest data from the national vaccination dashboard, 9.37 million individuals with comorbidities had been fully vaccinated as of March 9. However, only 2.07 million of them got booster shots.

COVID-19 has moved up to be the second leading cause of death in the country in 2021, according to the latest data from the Philippine Statistics Authority (PSA).

Heart diseases
The PSA reported a total of 105,723 deaths attributed to the coronavirus last year, accounting for 13.8 percent of all deaths in the Philippines in 2021. It was just behind ischaemic heart diseases—the cause of 136,575 deaths or 17.8 percent of total. Deaths due to heart diseases rose 29.7 percent from 105,281 recorded in 2020.

Based on data submitted to the PSA by city and municipal registrars nationwide, COVID-19 “with virus identified” logged 74,008 deaths last year, on top of 31,715 also attributed to the coronavirus but “not identified.”

National Statistician Dennis Mapa had explained that deaths caused by unidentified COVID-19 were not being reported by the Department of Health (DOH) in its tally as these were unlikely tested for the disease.

Identified and unidentified COVID-19 deaths in 2021 jumped 250.2 percent from 30,188 in 2020, the onset of the pandemic.

Last year, COVID-19 deaths with the virus identified climbed 694.4 percent from only 9,316 in 2020, while those unidentified increased by 51.9 percent from 20,872 in 2020.

“Figures specifically for deaths due to COVID-19 may differ from the one released by the DOH because the figures in this [report] were obtained from the certificates of death, particularly the descriptions written on the medical certificate portion therein as reviewed by the health officer of the local government unit concerned. On the other hand, the figures released by the DOH were obtained through a surveillance system,” the PSA explained.

Rounding up the top five causes of death in the Philippines in 2021 were: cerebrovascular diseases with 74,262, or 9.7 percent of the total; cancer with 59,503, (7.8 percent), and diabetes with 48,267 (6.3 percent).

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