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.
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.
This article originally appeared on Endocrinology Advisor
Kwan AC, Ebinger JE, Botting P, Navarrette J, Claggett B, Cheng S. Association of COVID-19 vaccination with risk for incident diabetes after COVID-19 infection. JAMA Netw Open. Published online February 1, 2023. doi:10.1001/jamanetworkopen.2022.55965