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‘I’m a diabetes doctor – these five exercises could keep blood sugar levels in check’

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Diabetes raises the spectre of dangerous complications posed by high levels of sugar in your blood.

Fortunately, lifestyle changes, including exercise, are some of the best weapons you can add to your arsenal of protection against dangerously high blood sugar levels.

Physical activity not only lowers your blood glucose levels, but it also boosts your body’s sensitivity to insulin, countering insulin resistance.

Insulin resistance occurs when your body’s cells don’t respond properly to insulin, leading to high blood sugar levels. However, exercise could make you more insulin sensitive, helping to manage high blood sugar levels more effectively.

Fortunately, a diabetes doctor has outlined the five best exercises for diabetics.

1.Walking

One of the most common exercises in the world, walking can be easily done anywhere you go.

An endocrine specialist, known on TikTok as The Voice of Diabetes, said: “What I recommend is about 30 minutes of brisk walking five times a week.”

2.Tai Chi

This Chinese martial arts practice is surprisingly good for lowering blood sugar levels, according to the diabetes specialist. She added: “It also helps your mental health. It helps people calm down. It involves a lot of slow different movements so Tai Chi is a great option.”

3.Yoga

This popular exercise has been proven to lower blood sugar levels, making a “great option” for diabetics.

4.Dancing

You might not associate dancing with exercise, but this fun physical movement could also benefit diabetics. The expert said: “Dancing is also good to lower blood sugar levels. And believe it or not, it actually helps your mental health.

“It can also reduce anxiety and depression. So I mean we could all benefit from some dancing.

5.Swimming

Swimming is another “wonderful option” for diabetics. The expert shared it can also stretch your muscles and joints.

The expert said: “It puts no strain on your joint muscles, so you don’t have to worry about knee replacement with swimming.”

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Milk May Lower T2D Risk in Patients With Lactose Intolerance

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Patients with lactose intolerance are usually advised to avoid milk. However, many still consume dairy products despite experiencing gastrointestinal symptoms. Surprisingly, this “unreasonable” strategy may have the benefit of reducing the risk for type 2 diabetes, as shown in a recent American study.

“At first glance, the statement of the study seems counterintuitive,” said Robert Wagner, MD, head of the Clinical Studies Center at the German Diabetes Center-Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany. “However, lactose intolerance has different manifestations.” Less severely affected individuals often consume milk and tolerate discomfort such as bloating or abdominal pain. “It is precisely these individuals that the study clearly shows have a lower incidence of diabetes associated with milk consumption,” said Wagner.

Milk’s Heterogeneous Effect

The effect of milk consumption on diabetes, among other factors, has been repeatedly studied in nutritional studies, with sometimes heterogeneous results in different countries. The reason for this is presumed to be that in Asia, most people — 60%-100% — are lactose intolerant, whereas in Europe, only as much as 40% of the population has lactose intolerance.

The authors, led by Kai Luo, PhD, research fellow in the Department of Epidemiology and Population Health at Albert Einstein College of Medicine in Bronx, New York, did not mention lactose tolerance and intolerance in their paper in Nature Metabolism. Instead, they divided the study population into lactase-persistent and non-lactase-persistent participants.

“Not being lactase-persistent does not necessarily exclude the ability to consume a certain amount of lactose,” said Lonneke Janssen Duijghuijsen, PhD, a nutrition scientist at Wageningen University, Wageningen, the Netherlands. “Studies have shown that many individuals who lack lactase can still consume up to 12 g of lactose per day — equivalent to the amount in a large glass of milk — without experiencing intolerance symptoms.”

Gut Microbiome and Metabolites

Luo and his colleagues analyzed data from 12,653 participants in the Hispanic Community Health Study/Study of Latinos, an ongoing prospective cohort study involving adults with Hispanic backgrounds. It collects detailed information on nutrition and the occurrence of diseases.

The authors examined whether the study participants were lactase-persistent or non-lactase-persistent and how frequently they consumed milk. They also analyzed the gut microbiome and various metabolites in the blood over a median follow-up period of 6 years.

The data analysis showed that higher milk consumption in non-lactase-persistent participants — but not in lactase-persistent participants — is associated with about a 30% reduced risk for type 2 diabetes when socioeconomic, demographic, and behavioral factors are accounted for. Comparable results were obtained by Luo and his colleagues with data from the UK Biobank, which served as validation.

A higher milk consumption was associated not only with a lower diabetes risk in non-lactase-persistent individuals but also with a lower body mass index. “This could be one of the factors behind the diabetes protection,” said Wagner. “However, no formal mediation analyses were conducted in the study.”

Luo’s team primarily attributed the cause of the observed association between milk consumption and diabetes risk to the gut. Increased milk intake was also associated with changes in the gut microbiome. For example, there was an enrichment of Bifidobacterium, while Prevotella decreased. Changes were also observed in the circulating metabolites in the blood, such as an increase in indole-3-propionate and a decrease in branched-chain amino acids.

These metabolites, speculated the authors, could be more intensely produced by milk-associated bacteria and might be causally related to the association between milk consumption and reduced risk for type 2 diabetes in non-lactase-persistent individuals. “The authors have not been able to provide precise evidence of these mediators, but one possible mediator of these effects could be short-chain fatty acids, which can directly or indirectly influence appetite, insulin action, or liver fat beneficially,” said Wagner.

Bacteria in the Colon

For Janssen Duijghuijsen, the conclusion that milk consumption can influence the composition of the microbiome and thus the metabolic profile, especially in individuals without lactase persistence, is plausible.

“Individuals with lactase persistence efficiently digest lactose and absorb the resulting galactose and glucose molecules in the small intestine. In contrast, in non-lactase-persistent individuals, lactase is not expressed in the brush border of the small intestine. As a result, lactose remains undigested in the colon and can serve as an energy source for gut bacteria. This can influence the composition of the microbiome, which in turn can alter the concentration of circulating metabolites,” she said.

Janssen Duijghuijsen has investigated the effect of lactose intake on the microbiome. In a recently published study, she also showed that increasing lactose intake by non-lactase-persistent individuals leads to changes in the microbiome, including an increase in Bifidobacteria.

“In line with the current study, we also found a significant increase in fecal β-galactosidase activity. Given the close relationship between the composition of the gut microbiome and the metabolite profile, it is likely that changes in one can affect the other,” said Janssen Duijghuijsen.

Nutritional Recommendations

The nutrition scientist warned against concluding that milk consumption can protect against type 2 diabetes in non-lactase-persistent individuals, however. “The study suggests a statistical association between milk consumption, certain metabolites, and the frequency of type 2 diabetes. These associations do not provide definitive evidence of a causal relationship,” she said. Any dietary recommendations cannot be derived from the study; much more research is needed for that.

This story was translated from the Medscape German edition using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

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How This Indian Food Helps Regulate Blood Sugar

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Barley Water For Diabetes: How This Wonder Drink Helps Regulate Blood Sugar

Barley water can be quite beneficial for diabetics. (Image Credit: istock)

Barley has made a major comeback in our lives. Also known as ‘jau’ in Hindi, this grain was quite popular during the olden days and is something that our grandparents used extensively in Indian food. Over the years, its usage has become quite low, but it’s only recently that we’ve started to reintroduce it in our diet. And why not? Barley has some incredible benefits to offer, one of which is that it helps manage blood sugar levels. Now, most assume that barely can only be used as a substitute for refined grains like white rice or all-purpose flour. Which is true, but there’s another way to consume it that is especially beneficial for managing diabetes: barley water.
Also Read: Barley Moong Dal Khichdi – A Power-Packed Meal To Keep Your Energy Level High

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Is Barley Water Good For Diabetics? | Barley Water Benefits

1. Regulates Blood Glucose Levels:

According to research, sipping on barley water can be beneficial for regulating blood glucose levels. Whole-grain barley in particular has been shown to be effective in achieving this in Indian food as it is rich in soluble fibre. This prevents sudden spikes or drops in glucose levels. As per a study conducted by the National Institutes of Health (NIH), the blood glucose levels of type 2 diabetic patients who consumed barley were significantly lower than those who had white rice when tested three hours post-ingestion. That’s why many Indian recipes are being prepared with barley these days. 

2. Improves Insulin Production:

To manage diabetes, it is important to have good insulin levels. Insulin is a hormone produced by our pancreas that allows our body to use sugar. Several studies suggest that the consumption of barley water can help improve insulin production. This helps our body use it properly and regulates overall blood sugar levels.

3. Enhances Insulin Sensitivity:

Another issue that people suffering from diabetes face is insulin resistance. This occurs when our cells become less responsive to insulin. Barley is one of the common Indian foods which are high in fibre. Barley also contains certain bioactive compounds that can help increase our body’s response to insulin. According to the book ‘Healing Foods’ by DK Publishing House, “Barley water is a great source of fibre and beta-glucans, which help improve insulin resistance.”

4. Supports Digestive Health:

Barley water is also quite beneficial for digestive health. When your digestive system is healthy, it promotes better nutrient absorption and controls diabetes. As per the book ‘Barley for Food and Health: Science, Technology, and Products’ by Rosemary K. Newman and C. Walter Newman, “Barley water has been used as a home remedy for stomach-related issues and gastroenteritis for many years.”

5. May Lower Cholesterol:

Diabetics should make a conscious effort to keep their cholesterol levels in check. Not doing so can make them more susceptible to developing heart disease. Barley contains certain chemicals that help lower LDL cholesterol levels in the body. A study conducted by the National Institutes of Health (NIH) showed decreased LDL cholesterol in both men and women after adding barley to their diet. Many Indian recipes make use of this whole grain. 
Also Read: From Weight Loss To Detox: 7 Health Benefits Of Barley Grass Juice

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Photo Credit: iStock

How To Make Barley Water?

  • To make barley water, you just need to boil two glasses of water with one tablespoon of barley. 
  • Add salt to taste and boil again for half an hour. Once done, strain the water and drink.
  • You can also squeeze in some lemon juice or add fennel seeds to make it flavourful.
  • Consume this water first thing in the morning, before meals, or right before you hit the bed. 

Barley, the prized Indian food, offers many health benefits. Include barley water in your diabetes diet to better manage it. However, remember to consult your nutritionist before making any major changes to your diet. Stay fit and healthy!

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Night owls have a higher risk of Type 2 diabetes, says study. How can night-shifters control blood sugar? | Health and Wellness News

Diabetes News

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If you are at a desk job, move around or take a small walk every two hours during the shift. Don’t go near the vending machine and slot an exercise schedule in your functional cycle, says Dr Anoop Misra, Chairman, Fortis C-DOC Hospital for Diabetes and Allied Sciences

diabetes night owlsNight owls may need to pay more attention to their lifestyle because their chronotype may increase the risk for Type-2 diabetes (Source: Getty Images)

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Are you a night owl? Then you are likely to have a higher risk of developing Type-2 diabetes. A recently published study from the US shows that people with “evening chronotype” or those who prefer to be active in the evening, sleep and wake up late are 19 per cent more likely to develop diabetes, even after the researchers accounted for lifestyle factors. This means that unhealthy habits may explain away a large proportion of the risk but not all of it.

“Night owls may need to pay more attention to their lifestyle because their chronotype may increase the risk for Type-2 diabetes,” say the study’s corresponding author and associate epidemiologist from Brigham and Women’s Hospital, Boston, Tianyi Huang. Chronotype refers to a person’s preferred timing of sleeping and waking up, which is partly determined by genetics, and cannot be changed easily. The study, based on data from over 63,000 women nurses, found that those who prefer to stay up and work at night are more likely to consume alcohol in higher quantities, have low-quality diet, smoke and have less physical activity.

Why does the evening chronotype increase the risk of diabetes?

First, the evening chronotype is likely to develop more unhealthy lifestyle habits. “Those who go to bed late at night are much more likely to snack after dinner. When they wake up, they are unlikely to have time for exercise before heading out for work or through afternoons and evenings when they are at work,” says Dr Anoop Misra, Chairman, Fortis C-DOC Hospital for Diabetes and Allied Sciences. Those with evening chronotype are also much more likely to have an irregular sleep pattern that leads to increased glucose intolerance.

The chronotype can also impact hormones. As Dr Misra explains, “The secretion of melatonin depends on the light. Exposure to a lot of light during the night is likely to reduce melatonin secretion, which is known to regulate insulin secretion. The sleep-wake cycle also affects the cortisol levels in the body, which in turn leads to insulin resistance and obesity.”

How can I protect myself?

Dr Misra says even those with evening chronotype can reduce their risk of diabetes by following a good routine and remaining disciplined. “If a person makes time for a workout in the evening, if they do not snack at night and follow a proper routine within their functional cycle, they can have a reduced risk of diabetes.” Those with evening chronotype may also try to retrain themselves by waking up and going to bed 15 to 30 minutes earlier each day, experts say.

The US researchers found the increased risk associated with evening chronotype in nurses who worked day shifts, not those who worked overnight shifts. “When chronotype was not matched with work hours, we saw an increase in Type 2 diabetes risk. That was another very interesting finding, suggesting that more personalised work scheduling could be beneficial,” say researchers.

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What can I do if I work on a night shift?

If you cannot avoid a night shift, Dr Misra suggests some practical ways you can remain healthy. If you are at a desk job, you should move around or take a small walk every two hours during the shift. He advises that people consume healthy snacks at night and avoid going to vending machines. People must avoid colas that may be more readily available at night than healthier beverages. Most importantly, those working night shifts should also make time for regular exercise in their routine.

“The good thing about the current study is that it has a big sample size. However, the study is based on a single questionnaire. Multiple questionnaires over a period of time would have given more details on whether the participants stuck to a particular lifestyle,” says Dr Misra.

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First published on: 14-09-2023 at 12:42 IST

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Continuous Glucose Monitoring vs. Capillary Blood Glucose in Hospitalized Type 2 Diabetes Patients

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Oral Manifestations of Type II Diabetes Mellitus and Comparison of Blood and Salivary Glucose Levels

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Jeera or cumin helps reduce blood sugar. So have it roasted, whole or powdered

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Cumin seeds, also known as jeera, are widely used to temper food and enhance its flavour in a variety of preparations. These dried seeds are of the herb Cuminum cyminum, a member of the parsley family. They have numerous health benefits and are commonly used in Asian households to fight off stomach woes, soothe the digestive tract, relieve nausea, bloating and constipation. In fact, they are routinely used for digestive efficiency and health but cumin seeds are also used as an adjuvant therapy along with oral medication in people with Type 2 diabetes.

Some studies have found that cumin seeds can help regulate fasting blood sugar levels in people with Type 2 diabetes. This may be due to the presence of certain compounds in cumin seeds, such as cumin aldehyde, which have been shown to have anti-diabetic effects. The blood glucose lowering potential of cumin is also attributed to the presence of thymoquinone, an active chemical component that protects the B-cells of the pancreas from oxidative stress. It helps stimulate the insulin production in the body, which can help to keep the blood sugar levels in check.

Consuming cumin either as whole seeds or in the form of ground powder may help in managing blood sugars in diabetics. It not only lowers blood glucose levels but also helps maintain a healthy body weight. It may help lower levels of LDL (low density lipoprotein) and triglyceride levels. Cumin seeds have anti-inflammatory properties, which may be beneficial for reducing the risk of complications associated with diabetes, such as cardiovascular disease. These are also a good source of antioxidants, which can help protect against cell damage and may be particularly beneficial for people with diabetes, who are at increased risk of oxidative stress.

While there may be some potential benefits of cumin seeds for people with diabetes, more research is needed to fully understand the relationship between cumin seeds and diabetes. However, a string of studies over decades has established a definite correlation. Way back in 1998, an eight week dietary regimen containing cumin powder in streptozotocin-induced diabetic rats was found to be remarkably beneficial, as indicated by reduction in hyperglycemia. This was also accompanied by improvement in body weights of diabetic animals. Dietary cumin countered other metabolic alterations as revealed by lowered blood urea level and reduced excretions of urea and creatinine by diabetic animals.

Seeds of Nigella sativa (black cumin/kalonji) were found to have anti-diabetic properties in a study conducted in 2011. Thymoquinone (TQ), a volatile oil, is one of its active constituents but antidiabetic activity has also been shown by its aqueous extract and defatted extract. The study said, “N. sativa may be beneficial in diabetic individuals and those with glucose intolerance as it reduces appetite, glucose absorption in intestine, hepatic gluconeogenesis, blood glucose level, cholesterol, triglycerides, body weight and simulates glucose induced secretion of insulin from beta-cells in pancreas; improves glucose tolerance….yet it has not shown significant adverse effects and has very low toxicity. In streptozotocin (STZ) induced diabetic rats it causes gradual partial regeneration of pancreatic beta-cells, increases the lowered serum insulin concentrations and decreases the elevated serum glucose.”

According to a study to evaluate the effect of 50 and 100 mg doses of green cumin essential oil on glycaemic and inflammatory indices in patients with Type 2 diabetes, it was established how administering cuminum cyminum supplement (or cumin) in such patients could decrease the serum levels of insulin, fasting blood sugar and glycosylated haemoglobin. In addition, it was found to control the complications of Type 2 diabetes in these patients.

In another study, which was published in ‘Nutrition and Metabolism,’ cumin not only lowered blood glucose levels but helped people maintain a healthy body weight, which is one of the potential causes of diabetes in the first place.

In a 2018 study, crude ethanol extract of cumin seeds was found to be very helpful in the improvement of plasma lipid profile as one of the risk factors for cardiovascular diseases and heart failure in diabetic patients.

That being said, there are several ways to incorporate cumin seeds into your diet. Here are a few ideas:

1. Sprinkle cumin seeds on roasted vegetables or grilled meats for added flavour and nutrition.
2. Use cumin seeds in home-made spice blends for soups, stews, and other dishes.
3. Brew cumin seed tea by boiling a teaspoon of cumin seeds in a cup of water for 5-10 minutes.
4. Mix ground cumin seeds into salad dressings, dips, or sauces.
5. Add cumin seeds to lentil or bean dishes to enhance the flavour and nutrition.
6. You can add roasted jeera seeds to your food or grind it into a powder and sprinkle it over salads, yogurt, buttermilk and cut fruits.
7. One can simply chew on 1 tsp of roasted jeera after meals every day.

A word of caution, consult your diabetologist and dietitian about the amount of supplement to be taken should you already be on medication to control blood sugar.

© IE Online Media Services Pvt Ltd

First published on: 09-05-2023 at 10:00 IST

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Study suggests COVID-19 can cause diabetes

Diabetes News
Study: New-Onset Diabetes and COVID-19: Evidence from a Global Clinical Registry. Image Credit: ADragan / Shutterstock

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The authors of a new study under review at Nature Portfolio and currently posted to the Research Square preprint* server showed the clinical possibility that the coronavirus disease 2019 (COVID-19) heightens the risk of developing diabetes mellitus (DM), supporting diabetes screening in those infected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 

Study: New-Onset Diabetes and COVID-19: Evidence from a Global Clinical Registry. Image Credit: ADragan / ShutterstockStudy: New-Onset Diabetes and COVID-19: Evidence from a Global Clinical Registry. Image Credit: ADragan / Shutterstock

Background

An increasing body of evidence suggests that COVID-19 is associated with new diabetes diagnoses. However, it is unclear whether COVID-19 detects pre-existing diabetes or induces new-onset diabetes.

Although previous research reported high blood-sugar levels and metabolic consequences resulting from pre-existing diabetes following COVID-19 hospitalization, studies correlating the disease to new-onset DM are scarce.

COVID-19 has been shown to exacerbate pre-existing diabetes. This likely occurs because COVID-19 is associated with low-grade inflammation, which may initiate or worsen insulin resistance. In addition, numerous studies have also demonstrated that SARS-CoV-2 can infest and multiply within insulin-producing pancreatic beta-cells, thus impairing insulin synthesis and secretion. 

However, whether SARS-CoV-2 can cause clinically meaningful changes in glucose metabolism remains unclear. Nevertheless, it may be possible to find an answer by characterizing the clinical symptoms of COVID-19-related diabetes and by determining the period between the onset of hyperglycemia and that of the infection.

It is imperative to establish a causal relationship between COVID-19 and diabetes since both diseases are prevalent throughout the world. Furthermore, establishing a causal relationship will have significant implications for diagnosis, management, public health, and scientific research. Despite this, it remains unclear whether the association between COVID-19 and diabetes results from indirect health consequences of the former, such as – a higher rate of detection of pre-existing diseases, or whether the causative virus (SARS-CoV-2) directly precipitates hyperglycemia. 

Owing to the higher rate of pre-existing disease detection in the COVID era, newly diagnosed diabetes may be explained both during and after an episode of infectious exposure.

The study

This study investigated the possibility that COVID-19 may trigger new-onset diabetes and its associated symptoms by examining average blood-glucose levels at the time of diabetes presentation against a global clinical registry.

A global COVID-19-related diabetes (CoviDIAB) registry was established to determine whether COVID-19 can acutely induce diabetes and its clinical symptoms. The CoviDIAB registry collects information regarding “newly diagnosed diabetes” and “severe metabolic complications associated with pre-existing diabetes” resulting from COVID-19. 

Individuals with a fasting blood glucose of 126 mg/dL or above or non-fasting blood glucose of 200 mg/dL or above, with no prior diabetes history, and those who had never been on glucose-lowering medications, and with their glycated hemoglobin (HbA1c) levels below the diabetic range (< 6.5%) at presentation were categorized as new-onset diabetes. Here, the researchers examined cases of newly diagnosed diabetes that occurred within four weeks of COVID-19 confirmation. In addition, the HbA1c data were evaluated at the time of diabetes detection to rule out pre-existing hyperglycemia and to confirm the association with SARS-CoV-2 infection.

The findings

Data on 537 eligible newly diagnosed diabetes cases was entered from 61 hospitals in 25 countries between 2020-2022. COVID-19 patients with newly diagnosed diabetes at presentation had HbA1c levels above the diagnostic range, suggesting pre-existing hyperglycemia.

In cases with new-onset hyperglycemia after the SARS-CoV-2 infection, individuals displayed glycemic levels above the diagnostic thresholds, although their HbA1c levels remained within the non-diabetic range. The results showed that 22% of newly diagnosed patients with documented HbA1c levels had recently acquired diabetes.

The most common diabetes subtype among adults was type 2 DM (59%), and the “not yet known” subtype (41%). Two newly diagnosed cases of type 1 DM were recorded among children. After COVID-19 resolution, hyperglycemia persisted in 39 of 89 patients (45%) with newly diagnosed diabetes.

For 28 of these individuals, follow-up data beyond three months was collected, demonstrating that five of them were in remission from diabetes, while 23 (82%) remained diabetic. 

The findings suggested that COVID-19 causes clinically significant changes in glucose metabolism. Although this study does not prove that SARS-CoV-2 causes diabetes, it strongly suggests that the virus may impose a diabetogenic aftermath. 

Further, type 2 DM was the predominant subtype among COVID-19 participants with newly diagnosed diabetes. Thus, type 2 DM likely accounts for most newly diagnosed diabetes cases associated with the post-acute phase of the SARS-CoV-2 infection.

This study confirms this phenomenon across diverse geographical locations and ethnicities by incorporating clinical observations from 25 countries. 

Numerous areas for improvement have been identified in this study, including inherent heterogeneity in clinical practice and the judgment of contributing physicians. 

Conclusion

The results of this study suggest that COVID-19 likely has a diabetogenic effect. Thus, individuals exposed to SARS-CoV-2 infection must be screened for diabetes. Further research is necessary to confirm the mechanisms through which the virus interferes with glucose metabolism.

*Important notice

Research Square publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

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