Okon-Umoren Aniebietabasi, Yaphe Sean, Smith Andrea, Passalacqua Karla D, Budzynska Katarzyna
Family Medicine, Henry Ford Health System, Detroit, USA.
Medical Education, Henry Ford Health System, Detroit, USA.
Cureus. 2024 Jul 6;16(7):e63983. doi: 10.7759/cureus.63983. eCollection 2024 Jul.
The development of new vaccines against the SARS-CoV-2 virus in response to the COVID-19 pandemic represents a milestone in the history of public health. However, due to the rapid development and short duration of these new vaccines, the full spectrum of side effects is not yet known. A 76-year-old man presented to the clinic for follow-up after being discharged from the emergency department for hyperglycemia. His medical history included well-controlled type 2 diabetes for two years, hypertension, and hyperlipidemia. He had recently noticed high home blood glucose readings over 400 mg/dL, and his hemoglobin A1c (mean 90-day glucose level) had increased from 6.5% to 12.6%. Notably, the patient reported having excellent health behaviors, including daily exercise, a closely monitored healthy diet, and regular blood glucose testing. After extensive endocrinology workup, the rapid change in blood glucose was thought to be due to his having recently received the COVID-19 messenger RNA (mRNA) vaccine. He was started on long- and short-acting insulin and a glucagon-like peptide-1 agonist (novel injectable type 2 diabetes medication), with improvement in blood glucose. He was tapered off all medications and remains on metformin 1,000 mg twice daily after one year.Whether the new COVID-19 mRNA vaccines directly incur hyperglycemia within certain groups of patients with diabetes is not known; thus, studies exploring the relationship between vaccine antigen binding and pancreatic function are needed.
为应对新冠疫情而研发的针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的新型疫苗，是公共卫生史上的一个里程碑。然而，由于这些新型疫苗研发迅速且使用时间较短，其副作用的全貌尚不清楚。一名76岁男性因高血糖从急诊科出院后到诊所进行随访。他的病史包括两年病情控制良好的2型糖尿病、高血压和高脂血症。他最近注意到家中血糖读数超过400mg/dL，糖化血红蛋白（平均90天血糖水平）从6.5%升至12.6%。值得注意的是，患者报告有良好的健康行为，包括每天锻炼、密切监测的健康饮食和定期血糖检测。经过广泛的内分泌检查，血糖的快速变化被认为是由于他最近接种了新冠信使核糖核酸（mRNA）疫苗。他开始使用长效和短效胰岛素以及一种胰高血糖素样肽-1激动剂（新型注射用2型糖尿病药物），血糖有所改善。一年后，他逐渐停用所有药物，目前仍每天服用两次1000mg二甲双胍。尚不清楚新型新冠mRNA疫苗是否会在某些糖尿病患者群体中直接引发高血糖；因此，需要开展研究探索疫苗抗原结合与胰腺功能之间的关系。
