key: cord-1003684-5uojs2ot
authors: Motawea, Karam R.; Abbas, Kirellos Said; AbdelQadir, Yossef Hassan; Monib, Fatma A.
title: New onset Diabetes Mellitus in a COVID-19 patient: A Case report
date: 2022-03-31
journal: Metabolism
DOI: 10.1016/j.metabol.2021.155105
sha: 53324d322967e6be8df2a18efbcad3493f93b483
doc_id: 1003684
cord_uid: 5uojs2ot

nan

adiposity variables with each insulin resistant marker. Methods: The Study of Cardiovascular Risk Factors in Adolescents (Portuguese acronym, ERICA) was a national school-based survey conducted in 2013-2014 that included 75,000 adolescents aged 12 to 17 years, of whom a subsample of 37,815 adolescents had fasting blood samples. We calculated linear regression coefficients of each insulin resistance marker stratified by age (12-14 years, 15-17) and sex. Insulin resistance markers were Homeostasis Model Assessment Insulin Resistance (HOMA-IR), Quantitative Insulin Sensitivity Check Index (QUICKI), Fasting insulin resistance index (FIRI), fasting glucose to insulin ratio (FGIR), Triglyceride/high-density lipoprotein (TG/HDL), Triglyceride/ glucose (TyG), Triglyceride/glucose-Body Mass Index (TyG-BMI), fasting insulin x fasting triglycerides (InsuTAG) and Metabolic Score of Insulin Resistance (METS-IR). Results: Our study suggests that FIeq for obesity, showed strong associations with insulin resistance markers. In adolescents aged 15 to 17 years, FIeq for elevated WC were greater than those for obesity and overweight for TG/HDL and TyG. Conclusion: Our study has confirmed the importance of adding WC measurements to clinical routine practice for identifying insulin resistance individuals, particularly in late adolescence. 

Background: According to the International Diabetes Federation, components of metabolic syndrome (MetS) are elevated waist circumference (WC), triglycerides (TG), high-density lipoprotein (HDL), blood pressure and fasting plasma glucose. It is still controversial whether the joint effect of MetS components is greater than that expected based on their independent effects with regard to diabetes in adolescents.

Objective: The aim was to evaluate interactions among combinations of metabolic syndrome components using diabetes as outcome. Methods: The Study of Cardiovascular Risk Factors in Adolescents (Portuguese acronym, ERICA) was a national school-based survey conducted in 2013-2014 that included 75,000 adolescents aged 12 to 17 years and a subsample of 37,815 adolescents had complete information for questionnaire, anthropometrics, blood pressure and fasting blood samples. We used poisson regression to calculate sex-, age-, obesity-and socioeconomic status-adjusted prevalence rate ratios to evaluate both the additive and multiplicative interactions between clustered MetS components and diabetes. The glucose component was excluded. Results: In the homogeneity strategy, prevalence ratios of high TG in the presence of low HDL (4.53 vs 1.23), as well as elevated WC in the presence of high TG (3.23 vs 0.73) were dissimilars, indicating positive additive and multiplicative interactions. When comparing observed and expected joint effects, both interactions had the same pattern, observed joint effects were two times greater than the expected. Conclusion: Although synergism was not present in all possible combinations, high TG and low HDL or elevated WC showed a greater association with the prevalence of type 2 diabetes mellitus in adolescents.

Abbreviations: MetS -metabolic syndrome WC -waist circumference TG -Triglyceride HDL -high-density lipoprotein 

Background: A while after SARS-CoV-2 infection broke out, different uncommon symptoms started to arise reflecting the pathogenesis of SARS-CoV-2 virus that affect different systems. Several studies pointed out a possible association between COVID-19 and a complicated clinical picture of Diabetes Mellitus. Previous case reports described new-onset type II diabetes, type I diabetes, and diabetic ketoacidosis (DKA). Case presentation: A case of a 73-year-old female patient presenting to the clinic with common COVID-19 symptoms, tested, and was found positive. For the following 3 days of management with mild COVID-19 protocol, she suffered from polyuria and polydipsia and presented to the ED, comatose and with a random blood sugar of 442 mg/dl despite no history of hyperglycemia or a family history of diabetes. After stabilizing her condition, management included COVID-19 medications at home and Vildagliptin 50 mg/ Metformin 1000 mg daily as anti-diabetic treatment. The patient was followed up for 7 months after recovery from the infection and was still taking anti-diabetic treatment. Discussion: We report a case of new onset type Diabetes Mellitus after Covid-19 infection in a previously healthy female who has negative family history of Diabetes and her last blood glucose and (HbA1C) tests were normal. The patient was followed up and continued on Vildagliptin 50 mg/ Metformin 1000 mg daily for the seven months follow up after recovery from Covid-19 infection. 

The duration of diabetes (years) was 3.1 (±2.7, maximum 8, 95% CI 2.4 to 3.8)

At 90 days, HbA1c in the range of 6.5-7% was achieved by five patients and one patient had HbA1c of 7.1%. 43% (n=27) patients at enrolment had normal HOMA2 Beta (N54.2), which changed to 88% (n=56)

resistance and, as a result, T2DM. The goal of this study was to look at the involvement of inflammatory mediators such as Tumor Necrosis Factor (TNF-) and White Blood Cells (WBCs) in mobilizing biological molecules, particularly those of an immunological origin and its possible role in the Insulin resistance. This study included 520 participants, 260 of whom had T2DM and 260 of whom were healthy controls. TNF-a (Tumor Necrosis Factor-a) concentrations in the blood were analysed using an ELISA approach, WBC count was determined using a Sysmax (Germany) hematology analyzer, and biochemical and immunoassay parameters were determined using fully automatic analyzers. T2DM patients had higher levels of potential pro-inflammatory cytokine (TNF-), as well as (WBC's). In T2DM patients, TNF-has a significant (p0.001) relationship with glycemic profile and insulin sensitivity when compared to healthy controls. Induction of inflammation and up-regulation of proinflammatory cytokines have long been thought to play a role in the pathophysiology of T2DM, and this work validates the favorable connection of TNF-with T2DM and hence insulin resistance and sensitivity. These can be used as early biomarkers in the diagnosis and prognosis of human diseases, such as Diabetes Mellitus. More research is needed to assist clinicians properly control and treat T2DM. 

Background and aims: Technology enabled precision nutrition, a combination of macro, micro and biota nutrients, along with Continuous Glucose Monitoring (CGM) have been demonstrated to be a key for reversal of diabetes. We sought to investigate the possible association between change in the glycated hemoglobin (HbA1c), insulin sensitivity (HOMA 2 Beta) and insulin resistance (HOMA 2 IR). These parameters were evaluated as the longitudinal follow up for three months Materials and methods: We conducted an initial analysis (n=63) of the ongoing randomized controlled trial of Twin Precision Treatment (TPT): a novel whole-body digital twin enabled precision treatment for reversing diabetes. The TPN program entailed detailed patient food intake information with CGM readings as inputs to a machine learning. The machine learning algorithm integrated these multi-dimensional data to predict personalized postprandial glucose response. This leads to a predictive model, which enabled daily precision nutrition guidance to the patient. Physicians utilized, TWIN app recommendations based on the CGM values as a decision tool to down titrate medications