key: cord-0872207-1mh3ctly
authors: Potier, L; Julla, J B; Roussel, R; Boudou, P; Gauthier, D C; Ketfi, C; Gautier, J F
title: COVID-19 symptoms masking inaugural ketoacidosis of type 1 diabetes
date: 2020-05-21
journal: Diabetes Metab
DOI: 10.1016/j.diabet.2020.05.004
sha: a04e4c55dfe6043eeb55276a60a415e8688d9c6c
doc_id: 872207
cord_uid: 1mh3ctly

nan

incidental. This case highlights the fact that clinicians must be aware of other acute diseases that can be veiled by COVID-19 symptoms.

In this particular case, COVID-19 most probably triggered the DKA, but was not causal in the occurrence of T1D. Indeed, in the course of T1D, the cell-mediated autoimmune destruction of β cells in the pancreas leading to hyperglycaemia begins some time (0.5-1.5 years) before the onset of its symptomatic manifestations [2] . However, that COVID-19 could exacerbate DKA as a precipitating factor cannot be excluded, as it has been demonstrated that SARS-CoV-2, through binding to its ACE-2 receptor expressed in β cells, can damage islets and, thus, reduce insulin release [3] .

All authors report no conflict of interest in relation with the manuscript. 

American Diabetes A. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020

Staging presymptomatic type 1 diabetes: a scientific statement of JDRF, the

Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes