medwireNews: Two large cohort studies have demonstrated an increased likelihood of being diagnosed with type 2 diabetes in the months following SARS-CoV-2 infection.
The data for both studies come from healthcare databases rather than hospitals, so encompassing mild to severe COVID-19, and one shows an increasing diabetes risk with greater severity of disease.
This study, published in The Lancet Diabetes & Endocrinology, involved 181,280 people with a positive COVID-19 test from the US Department of Veterans Affairs plus 4,118,441 without. None of the participants had diagnosed diabetes at baseline.
The other study, which is published in Diabetologia, involved 35,865 people who had COVID-19 and 35,865 propensity-matched controls who had an acute upper respiratory tract infection, all identified in a German primary care database.
During 1 year of follow-up of the German cohort, the rates of type 2 diabetes were 15.8 and 12.3 per 1000 people in people who had COVID-19 and controls, respectively, which equated to a significantly increased incident rate ratio of 1.28.
This increased risk persisted over the whole year and was not observed for other forms of diabetes, report Wolfgang Rathmann (Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf) and co-researchers.
In the US study – by Yan Xie and Ziyad Al-Aly from VA Saint Louis Health Care System in Missouri – follow-up excluded the first 30 days post-COVID. The 12-month incident diabetes rates were 48.38 per 1000 people among COVID-19 survivors and 34.93 per 1000 people among the controls, giving a significant adjusted hazard ratio for diabetes of 1.40 and an excess burden of 13.46 per 1000 people.
There was also a significantly increased hazard ratio of 1.85 for being newly prescribed antihyperglycemic medications among people with COVID-19 versus controls, with an excess burden of 12.35 per 1000 people. These risk increases were seen across categories defined by age, sex, race, BMI, deprivation score, and baseline risk for diabetes.
The risk for diabetes was highest in people who required intensive care for COVID-19, at a rate of 123.48 per 1000 people, but was significantly elevated even in those who were not hospitalized, at a rate per 1000 people of 42.70 compared with 34.42 in controls.
In a commentary linked to the US study, K M Venkat Narayan and Lisa Staimez, both from Rollins School of Public Health in Atlanta, Georgia, USA, say that if these findings are confirmed then follow-up screening for diabetes will need to be incorporated into COVID-19 management guidelines.
“The long-term implications of SARS-CoV-2 infection increasing diabetes risk are profound,” write the commentators, noting the still increasing prevalence of diabetes.
They say that considering the huge number of COVID-19 cases globally, “any COVID-19-related increases in diabetes incidence could lead to unprecedented cases of diabetes worldwide—wreaking havoc on already over-stretched and under-resourced clinical and public health systems globally, with devastating tolls in terms of deaths and suffering.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group
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