Diabetes Risk After COVID-19 Infection Higher in Unvaccinated

Contracting COVID-19 infection is associated with a higher incidence of diabetes, and unvaccinated patients are at higher risk for developing diabetes after COVID-19 infection than vaccinated patients, according to study findings published in JAMA Network Open.

Researchers conducted a retrospective cohort study of adult patients who were treated for at least 1 case of COVID-19 infection in the Cedars-Sinai Health System in Los Angeles, California, from March 2020 to June 2022. They used International Statistical Classification of Diseases, Tenth Revision (ICD-10) codes to identify patients with cardiometabolic diseases (ie, hypertension, hyperlipidemia, and diabetes) who were newly reported before or after COVID-19 infection.

To account for disruptions in health care access during the pandemic, the researchers also compared the odds of a new cardiometabolic diagnosis with the odds of a “benchmark” diagnosis that would theoretically not be caused by a COVID-19 infection, such as urinary tract infection or gastroesophageal reflux disease. These benchmark diagnoses were also attained using ICD-10 codes.

The study cohort (n=23,709) comprised 54% (n=12,706) women and 46% (n=10,981) men; there were 22 participants who did not have their sex identified.

Following COVID-19 infection, participants had the highest odds of developing new-onset diabetes (odds ratio [OR], 2.35; 95% CI, 1.94-2.89; P <.001), followed by hypertension (OR, 1.54; 95% CI, 1.35-1.76; P <.001), the benchmark diagnoses (OR, 1.42; 95% CI, 1.25-1.61; P <.001), and hyperlipidemia (OR, 1.22; 95% CI, 1.03-1.47; P =.03). The odds ratio for diabetes in vaccinated vs unvaccinated patients was 0.63 (95% CI, 0.47-0.85; P =.002), 0.54 for hypertension (95% CI, 0.42-0.69; P <.001), and 0.55 for hyperlipidemia (95% CI, 0.41-0.73; P <.001). However, when compared directly with the benchmark diagnoses, only the risk for new-onset diabetes after COVID-19 was significantly elevated (OR, 1.55; 95% CI, 1.24-2.02; P <.001).

Limitations of the study include the reliance on diagnostic coding, lack of infection severity indices, and insufficient sample size and statistical power.

The study authors conclude, “In this cohort study, COVID-19 infection was associated with increased risk of diabetes, consistent findings of a meta-analysis.   Our results suggest that this risk persisted as the Omicron variant became predominant, and the association remained even after accounting for temporal confounders.”

Disclosure: Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.