The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has a complex relationship with blood sugar regulation. Understanding how this viral infection interacts with the body’s glucose control systems is important for individuals with and without a prior history of diabetes. This article explores the impacts of COVID-19 on blood sugar levels, from direct effects to long-term implications, and offers guidance on managing these changes.
COVID-19’s Direct Impact on Blood Sugar
COVID-19 can directly influence blood sugar levels, leading to both elevated blood sugar (hyperglycemia) and, less commonly, low blood sugar (hypoglycemia). These effects have been observed in individuals regardless of a prior diabetes diagnosis. Hyperglycemia is common in hospitalized COVID-19 patients, and these elevated levels during acute infection are associated with poorer outcomes. This disruption in glucose control can occur even in individuals without pre-existing diabetes, highlighting the virus’s ability to interfere with metabolic processes during acute illness.
How the Virus Influences Glucose Regulation
The SARS-CoV-2 virus enters human cells through the Angiotensin-converting enzyme 2 (ACE2) receptor. This receptor is found in the lungs and on cells in other organs, including the insulin-producing beta cells in the pancreas. The virus’s interaction with these pancreatic cells may directly impair their ability to produce and release insulin, a hormone that regulates glucose.
Beyond direct cellular effects, the body’s immune response to COVID-19 plays a role in blood sugar changes. Severe infection can trigger an inflammatory response, sometimes referred to as a “cytokine storm,” which contributes to insulin resistance. Insulin resistance means the body’s cells do not respond effectively to insulin, leading to higher blood sugar levels.
Additionally, the stress of severe illness causes the release of hormones like cortisol, which naturally increase blood glucose. Medications commonly used to treat severe COVID-19, such as corticosteroids, are also known to raise blood sugar levels, further complicating glucose management.
New Diabetes and Worsened Conditions
COVID-19 has been linked to new-onset diabetes in individuals with no prior diagnosis. While some cases may represent the unmasking of pre-existing, undiagnosed diabetes or the acceleration of prediabetes due to inflammatory stress, evidence suggests COVID-19 can trigger new-onset diabetes. Studies indicate that individuals who have had COVID-19, even with mild symptoms, may have an elevated risk of developing diabetes in the months following infection.
For those already living with diabetes, COVID-19 can worsen their condition. The infection often leads to poorer glycemic control and increased insulin requirements, particularly in severe cases. This exacerbation increases the risk of serious complications such as diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), which are medical emergencies characterized by extremely high blood sugar and other metabolic imbalances. The metabolic disruptions can also persist as part of “Long COVID,” where individuals experience lingering blood sugar issues even after the acute infection resolves.
Managing Blood Sugar During and After COVID-19
Monitoring blood sugar levels is important, especially for individuals with diabetes or those at risk. Regular checks help identify high or low blood sugar, allowing for timely intervention. Maintaining adequate hydration by drinking plenty of water is beneficial, as illness can affect fluid balance and blood sugar levels.
Following a balanced diet and being mindful of carbohydrate intake can support stable blood sugar. Individuals should be aware that some over-the-counter medications for cold or flu symptoms can affect blood sugar levels. Recognizing symptoms of high blood sugar, such as increased thirst and frequent urination, or low blood sugar, like dizziness and confusion, is important for prompt action.
Consulting healthcare professionals for personalized advice, medication adjustments, and follow-up care is recommended, particularly for persistent issues or new symptoms related to blood sugar control after COVID-19.