Adults with type 1 diabetes experience rise in glucose levels after COVID-19 booster
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Key takeaways:
- Adults with type 1 diabetes had an increase in glucose levels 2 to 3 days after receiving a COVID booster vaccine.
- More studies are needed to see if other vaccines increase glucose levels in type 1 diabetes.
SAN DIEGO — Adults with type 1 diabetes may experience increases in glucose and insulin resistance in the days after receiving a COVID-19 booster vaccine, according to a presenter at the American Diabetes Association Scientific Sessions.
“Although the mean glycemic elevation was quite mild overall across the entire cohort, in some people with type 1 diabetes, glycemia post-vaccination can be profoundly elevated,” Andrew P. Demidowich, MD, assistant professor in the division of endocrinology, diabetes and metabolism in the department of medicine at Johns Hopkins Medicine, told Healio. “Clinicians and patients should be more vigilant with their glycemic testing and management for at least 3 to 4 days post-vaccination.”
Demidowich and colleagues conducted a small prospective outpatient study of 21 adults with type 1 diabetes who received a COVID-19 booster vaccine (62% women; mean age, 47.4 years). A Dexcom G6 continuous glucose monitor was given to each participant at baseline. Adults received a COVID-19 booster 3 to 4 days after baseline. Six days after vaccination, participants had the CGM removed. The change in daily insulin resistance, mean daily glucose, daily insulin dose, time in range and glycemic variability were collected from CGM at baseline and 6 days post-vaccination.
Of the cohort, 62% received the Pfizer-BioNTech booster and 38% received the Moderna booster. The booster was the fourth COVID-19 vaccination dose for 71% of participants.
At day 2 and day 3 post-vaccination, the study group had a higher mean glucose level compared with baseline. Mean glucose later declined closer to baseline levels at day 4 and day 5. Higher insulin resistance was observed at day 2 compared with baseline before dropping to levels similar to baseline at days 3 to 5. There were no differences in total daily insulin dose, time in range or glycemic variability between baseline and any time point post-vaccination.
Demidowich said the most surprising finding in the study was how the increase in glucose level persisted for 2 days after vaccination. He said the study shows why providers need to advise adults with type 1 diabetes to monitor their glucose levels more closely in the days following a COVID-19 vaccination.
“Additionally, similar studies are needed to test the glycemic effects of other vaccines, such as influenza, in people with diabetes,” Demidowich said.
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Zilbermint M, et al. 1486-P. Presented at: American Diabetes Association Scientific Sessions; June 23-26, 2023; San Diego (hybrid meeting).
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