Mänd Sarah-Ålivia, Sjöholm Åke
Department of Internal Medicine, Division of Endocrinology and Diabetology, Gävle Hospital, Gävle SE-80324, Sweden.
Department of Internal Medicine, Division of Endocrinology and Diabetology, Gävle Hospital, University of Gävle, Gävle SE-80324, Sweden.
JCEM Case Rep. 2024 Dec 13;3(1):luae228. doi: 10.1210/jcemcr/luae228. eCollection 2025 Jan.
We report a case of new-onset, nonautoimmune, nonketotic, and noninsulinopenic type 2-like diabetes in a previously normoglycemic middle-aged man debuting after vaccination against COVID-19. This was not a mild or short-lived glucose intolerance, but severe and long-standing hyperglycemia with a high glycated hemoglobin level. However, the course of the diabetes was highly atypical and surprising in that it spontaneously disappeared after a few months and did not recur despite the patient being off all antidiabetic drugs for several months and without any changes in body weight or lifestyle. The mechanisms by which severe diabetes unfolded and later remitted in this patient remain elusive. Nonetheless, and notwithstanding whether or not there was a cause-and-effect relation between the vaccinations and his diabetes, the highly atypical course of spontaneously remitting nonautoimmune diabetes lends itself to mechanistic efforts aimed at understanding the biology and pathophysiology of insulin-producing β cells in health and disease. This case report should not be construed as vaccine skepticism or deter anyone, especially with diabetes/obesity, from vaccination against COVID-19. However, it calls for increased vigilance among health care providers for unusual and unexpected metabolic effects of COVID-19 and its vaccines.
我们报告了一例新型、非自身免疫性、非酮症性且非胰岛素缺乏型的2型糖尿病病例，患者为一名此前血糖正常的中年男性，在接种新冠疫苗后发病。这并非轻度或短暂的葡萄糖不耐受，而是严重且长期的高血糖，糖化血红蛋白水平很高。然而，该糖尿病病程极具非典型性且令人惊讶，因为几个月后血糖自发恢复正常，且在患者停用所有抗糖尿病药物数月、体重和生活方式均无任何变化的情况下也未复发。该患者严重糖尿病发生及随后缓解的机制仍不清楚。尽管如此，无论疫苗接种与他的糖尿病之间是否存在因果关系，这种自发缓解的非自身免疫性糖尿病的高度非典型病程有助于开展机制研究，以了解健康和疾病状态下胰岛素分泌β细胞的生物学和病理生理学。本病例报告不应被解读为对疫苗的怀疑，也不应阻止任何人，尤其是糖尿病/肥胖患者接种新冠疫苗。然而，它呼吁医疗保健人员提高警惕，关注新冠病毒及其疫苗不寻常和意外的代谢影响。
