key: cord-0935257-81p5w2xm
authors: Seow, Cherng Jye; Wei Choon Koh, Alvin; Lian, Joyce Xia; Dalan, Rinkoo; Boehm, Bernhard Otto
title: Non autoimmune type 1B diabetes after mild COVID‐19: Report of three cases
date: 2021-02-03
journal: Diabetes Metab Res Rev
DOI: 10.1002/dmrr.3438
sha: 0415ae11829828f0d91da71a167276d055e0baaa
doc_id: 935257
cord_uid: 81p5w2xm

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It remains to be seen whether the reported patients will require longterm insulin or will have periods with no insulin requirements. The relatively high insulin requirement suggests impairment of insulin signalling due to concomitant insulin resistance. It is known that the SARS-CoV-2 virus utilises the angiotensin-converting enzyme 2 (ACE2) which is highly expressed in the pancreas 8 and may protect the function of insulin-producing beta cells by improving the function of islet microvascular endothelial cells. In the skeletal muscle, as a major target of insulin action, the ACE-2-Ang(1-7)-Mas axis has been described to decrease insulin resistance. 8 Hence the use of these receptors and subsequent downregulation of these pathways may partially explain this presentation. 

The authors would like to thank Dr. Peter D. Burbelo, NIH, Bethesda, USA, for making available induced pluripotent stem cell assays for quantification of glutamic acid decarboxylase, insulinoma-associated antigens 2 and ZnT8 autoantibodies.

The authors declare that there are no conflict of interests.

C. J. Seow was the endocrinologist looking after these patients and he conceptualised the study, collected the information on the patients, [Correction added on 22 February 2021, after first online publication: Peer review history statement has been added.]

The peer review history for this article is available at https://publons. com/publon/10.1002/DMRR.3438.

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