Covid-19 can trigger new-onset diabetes in previously healthy people

This information is sourced from the Primary Care Diabetes Society (PCDS):

• Covid-19 can trigger new-onset diabetes and can result in life-threatening DKA and/or hyperosmolar hyperglycaemic state
• New-onset diabetes affects >14% of people admitted to hospital with Covid-19
• Corticosteroids should not normally be prescribed to treat Covid-19 that is not severe or critical, because there is risk of harm
• Some people with new-onset diabetes may be discharged from hospital on doses of glucose-lowering therapies, including insulin, that may need adjustment in subsequent days or weeks
• Concern has arisen regarding overlooked new-onset type 1 diabetes in children and young people
• Breathlessness due to acidosis in DKA may be wrongly attributed to Covid-19, resulting in late presentation, risking increased morbidity

The PCDS advise GPs to:

• Remain vigilant for symptoms of new-onset type 1 diabetes, particularly in children and young people who are unwell
  • Consider the 4Ts – Toilet, Thirsty, Tiredness, Thinner
  • Check urine for glucose and ketones, and do a finger-prick glucose test. If the random point-of-care glucose is >11.0 mmol/L, refer immediately
• Capillary glucose and urinary ketone levels should be checked in people presenting acutely unwell with suspected Covid-19 or possible diabetes-related emergency