Dual insulin resistance causes: how frequently type 2 diabetes mellitus and COVID-19 infection caused diabetic ketoacidosis? a case report

Abstract

Background and importance: Infection with coronavirus disease 2019 (COVID-19) worsens insulin resistance and causes diabetic ketoacidosis (DKA). Patients with COVID-19 infection who develop DKA run the risk of worse outcomes. In both diabetic and nondiabetic patients, the COVID-19 infection may hasten the development of ketoacidosis, which could have negative effects on the fetus. Case presentation: A 61-year-old retired Black African female was taken into the emergency room on 22 April 2022, with significant complaints of frequent midnight urination, shortness of breath, blurry vision, and tingling in her hands and feet. On a chest radiography, bilateral diffuse, patchy airspace opacities that might be due to multifocal pneumonia or viral pneumonia were seen. The severe acute respiratory syndrome infection was confirmed by real-time reverse transcription-PCR testing from nasopharyngeal swabs. She received intravenous fluids and an intravenous insulin infusion and monitored her blood electrolyte levels as part of her treatment. She received subcutaneous enoxaparin 80 mg every 12 h a day for prophylaxis of deep venous thrombosis due to her confirmed COVID-19. Clinical discussion: In a large number of patients, COVID-19 has the ability to trigger DKA, and type 2 diabetes mellitus amplifies the underlying COVID-19 infection. Diabetes mellitus and COVID-19 are noted to have a reciprocal relationship in this regard. Conclusions: By making the body resistant to insulin and raising blood sugar levels, a COVID-19 infection can cause DKA. It is probable that her severe acute respiratory syndrome coronavirus 2 infection has a detrimental effect on the pancreatic beta cells, which are responsible for her body producing insufficient levels of insulin.