Riddhi Das Gupta MBBS, MD, DM Endocrinology, Department of Endocrinology, Avica Atri, MBBS, Abhishek Bhattacharjee, MBBS, Ramprasad Gorai, MBBS, MD, Arindam Hazra, MBBS, MD, Brojen Chowdhury, MBBS, MD, Dhriti Sundar Dutta, MBBS MD, Healthworld Hospitals, Durgapur, West Bengal, India Mousumi Lodh, MBBS MD (Biochemistry), Arunangshu Ganguly MBBS, DNB (Cardiology), Healthworld Hospitals, Durgapur, West Bengal, India.

      This abstract was presented at the 9th JPEF Annual Global Diabetes Convention 2021 and won the first prize for the best oral presentation.

      Recent researches suggest a bidirectional relationship between COVID-19 infection and new-onset diabetes (NOD), with an increasing number of NOD presenting with Diabetic Ketoacidosis (DKA), though the exact pathogenesis in them is yet to be defined substantially. A prospective study from India over eight months including age and sex-matched 20 NOD presenting with DKA (NOD-DKA), 20 Type 1A DM (GAD/IA-2 positive), 20 Type 2 DM and 20 . non-diabetic controls revealed a strong association between Covid-19 metabolic strategy and NOD. The subjects included in the study underwent a 75g- OGTT(oral glucose tolerance test) with estimation of glucose, C-peptide, free fatty acid (FFA) and insulin levels at 0,15,30,45,60,90,120,150 and 180 minutes.

      The results showed that at baseline, ISRinNOD-DKA (n=20) group was significantly reduced compared to Type 2 DM (p=0.01) but was similar to Type 1A DM (p=0.15). Interestingly, n=16 (80%) of NOD-DKA had dramatic recovery in their ISR at 4 months and 8 months follow-up compared to Type 1A DM(all p&rt;0.05), and achieved remission from insulin therapy (NOD-Remission), while n=4 (20%) continued to have poor ISR similar to Type 1A DM (all p>0.05) at serial follow-ups and persisted to be insulin-dependent (NOD-Nonremission).

      This is the first prospective study to provide metabolic and metabolomics insights into a unique form of Ketosis-prone Diabetes associated with new-onset DKA in previously normoglycemic COVID-19 positive Indians.