COVID-19 infection increases risk for incident diabetes by 64%
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The risk for incident type 1 or type 2 diabetes increases after a COVID-19 infection, according to findings from a systematic review and meta-analysis published in Metabolism: Clinical and Experimental.
In data from 11 cohorts composed of more than 4.5 million people diagnosed with COVID-19 and more than 42 million controls, the risk for being diagnosed with new-onset diabetes was 64% higher in those who had recently contracted COVID-19 compared with controls who did not have COVID-19. An increased risk for diabetes in the COVID-19 group was observed in both men and women, across all age groups and in all geographic regions.
“In summary, there is a significant association between COVID-19 infection and the development of diabetes in the general population,” Xuping Song, PhD, lecturer in the department of social medicine and health management, School of Public Health at Lanzhou University in China, and Long Ge, PhD, an academic researcher in the Evidence-based Social Science Research Center, School of Public Health at Lanzhou University, and colleagues wrote. “Therefore, the management, prevention and screening of diabetes in COVID-19 survivors should be strengthened.”
Researchers conducted a systematic search of the Embase, PubMed, Cochrane Central Register of Controlled Trials and Web of Science databases from inception through June 8, 2022, for cohort studies analyzing the association between COVID-19 infection and incident diabetes. Data on study characteristics, participants, study design and the rate of risk for diabetes were extracted. The estimated relative risk for all types of diabetes were estimated using the pooled risk in the studies.
The meta-analysis included 10 studies analyzing 11 cohorts. Seven cohorts included people from the U.S., three included people in Europe, and one was a global cohort. Eight of the 11 cohorts examined associations with incident type 2 diabetes and the other three focused on type 1 diabetes. Two of the 10 studies in the meta-analysis were preprinted.
There were 47,120,129 people included in the study (mean age, 41 years), of whom 4,520,587 were diagnosed with COVID-19 and the remaining were controls without COVID-19. In a random-effects model, people who contracted COVID-19 had an increased risk for any type of diabetes compared with controls (RR = 1.64; 95% CI, 1.51-1.79). There was a stronger increased risk for developing type 2 diabetes after a COVID-19 infection (RR = 1.78; 95% CI, 1.56-2.02) compared with the risk for developing type 1 diabetes (RR = 1.42; 95% CI, 1.38-1.46; P for interaction = .001).
There was no significant difference in the risk for incident diabetes after a COVID-19 infection across age groups, races and geographic regions. Men who were diagnosed with COVID-19 had a slightly greater increased risk for diabetes (RR = 1.45; 95% CI, 1.37-1.53) compared with women (RR = 1.35; 95% CI, 1.3-1.41; P for interaction = .05).
“The development of diabetes in patients with COVID-19 has complex additive effects on multiple diseases and adverse outcomes,” the researchers wrote. “Although relevant issues remain to be further explored and explained, the evidence in this meta-analysis suggests that increased attention and care for diabetes risk in patients with COVID-19 should be addressed in response to a public health problem that may be extremely serious in the future.”
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