Daily Dose: COVID-19 Infection Increases Risk of Type 2 Diabetes

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On February 16, 2023, we reported on a study published in JAMA Network Open that examined the association of COVID-19 vaccination with the risk for incident type 2 diabetes (T2D) after COVID-19 infection.

The study

Tapping the Cedars-Sinai EHR data, researchers used a self-controlled exposure-crossover design to estimate the odds of a new cardiometabolic diagnosis occurring 90 days after compared to 90 days before COVID-19 infection. Given the potential for temporal confounders related to health care disruptions during the pandemic, the research team compared the odds of a new cardiometabolic diagnosis with those of a new benchmark diagnosis, ie, urinary tract infection and gastroesophageal reflux, as a marker of health care engagement. In analyses using multivariable logistic regression models, researchers estimated the odds ratio (OR) for a new cardiometabolic diagnosis vs a new benchmark diagnosis occurring 90 days after vs 90 days before infection. Adjustments were made for age, sex, timing of infection, and COVID-19 vaccination status. Timing of infection was identified as either before or after the emergence of the Omicron variant. The final cohort numbered 23 709.

In the 90 days post COVID-19 infection, rates of new onset cardiometabolic disease and benchmark diagnoses both were higher than before infection. The highest odds postinfection were observed for new-onset diabetes, followed by hypertension, benchmark diagnoses, and hyperlipidemia. In multivariable-adjusted models, when compared to the risk observed for new benchmark diagnoses after and before COVID-19 infection, the risk of new-onset T2D was significantly elevated. Vaccination status did make a difference, the team found, with risk for new onset T2D after infection higher among unvaccinated patients than vaccinated persons. The interaction between vaccination status and diabetes diagnosis, however, did not reach statistical significance.

Note from authors

"Our results verify that the risk of developing Type 2 diabetes after a COVID-19 infection was not just an early observation but, in fact, a real risk that has, unfortunately, persisted through the Omicron era."

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