September 2, 2020

What can metabolomics show us about the severity of COVID-19 in diabetic patients?

Michael Maile, M.D., M.S., has received an ADA grant to investigate why diabetic patients are at greater risk of multiple organ failure with COVID-19

Michael Maile, MD
 

Michael D. Maile, M.D., M.S., has received a grant from the American Diabetes Association to research the metabolic contributions to multiple organ failure in diabetic patients with COVID-19.

“Patients with a history of diabetes have worse outcomes with COVID – meaning, they end up intubated more often, stay on the ventilator for longer periods of time, require dialysis more frequently, and have a higher mortality rate.” said Maile, assistant professor of anesthesiology. “These funds will allow us to study how altered metabolic pathways contribute to this relationship. We will attempt to elucidate these abnormalities by discovering the distinct profile of metabolite changes they produce in the plasma. This will allow us to deduce the pathways that are up- or down-regulated in diabetic patients who develop severe disease.”

Samples collected at Michigan Medicine are stored at the Central Biorepository and will be used to identify differences in the plasma metabolome, lipidome, and inflammatory proteome. Maile will work with the Michigan Regional Comprehensive Metabolomics Resource Core (MRC)2 and others to determine how concentrations of these substances change over time. Differences between those with and without diabetes, and those who do and do not develop severe disease will reveal the metabolic pathways most important in this process. 

“People often think of diabetes as just high blood sugar, but there are many other metabolic changes that go along with diabetes,” Maile said. “These assays can detect even subtle changes in fatty acids, amino acids, carbohydrates, and other metabolites that reflect changes in the substrate delivery to cells and disrupted cellular metabolism. Combining these signals with changes in the inflammatory proteome will help us understand why diabetics develop worse disease.”

These metabolic signatures may one day improve our ability to identify at-risk patients and produce new therapeutic targets that can be exploited to improve the care of diabetic patients.