Yes, COVID-19 increases a person’s diabetes risk—but vaccination may help

New-onset type 2 diabetes is more likely among patients who have had COVID-19, according to new data published in JAMA Network Open.[1]

The study’s authors examined data from nearly 24,000 patients with at least one confirmed COVID-19 diagnosis. All patients were treated at a single high-volume health system from 2020 to 2022. The average age was 47.4 years old, and 54% of patients were women.

Overall, researchers found, the rates of new-onset diabetes, hypertension and hyperlipidemia were all higher among patients in the 90 days after COVID-19 than in the 90 days prior to COVID-19. After making key adjustments, the risks of hypertension and hyperlipidemia were no longer any higher among patients after a COVID-19 infection—but the risk of new-onset diabetes remained significantly higher.

“Our results validate early findings revealing a risk of developing type 2 diabetes after a COVID-19 infection and indicate that this risk has, unfortunately, persisted through the Omicron era,” corresponding author Alan Kwan, MD, a cardiologist with the Smidt Heart Institute at Cedars-Sinai, said in a prepared statement. “This research study helps us understand—and better prepare for—the post-COVID-19 era of cardiovascular risk.”

Does vaccination impact the risk of new-onset diabetes among COVID-19 patients?

Kwan et al. found that the combined risk of developing new-onset type 2 diabetes after COVID-19 exposure was 2.1%. The risk among patients who were vaccinated against COVID-19 at the time of their exposure was 1%; the risk among patients who were not vaccinated against COVID-19 at the time of their exposure was 2.7%.

“These results suggest that COVID-19 vaccination prior to infection may provide a protective effect against diabetes risk,” Kwan said. “Although further studies are needed to validate this hypothesis, we remain steadfast in our belief that COVID-19 vaccination remains an important tool in protecting against COVID-19 and the still-uncertain risks that people may experience during the post-infection period.”  

COVID-19 as a ‘disease accelerator’

Senior author Susan Cheng, MD, director of Cardiovascular Population Sciences at the Smidt Heart Institute, noted in the same statement that these findings could help teach clinicians a great deal about the long-term impact COVID-19 can have on a person’s body.

“Although we don’t yet know for certain, the trends and patterns that we see in the data suggest that COVID-19 infection could be acting in certain settings like a disease accelerator, amplifying risk for a diagnosis that individuals might have otherwise received later in life,” she said. “So, it could be that instead of being diagnosed with diabetes by age 65, a person with pre-existing risk for diabetes might—after a COVID-19 infection—be more likely to develop diabetes by age 45 or 55.”

There is a similar trend seen at long-COVID clinics with new onset atrial fibrillation (AFib) in younger patients who previously had COVID. While some patients might have risk factors like family history that make them more prone to developing AFib, it is appearing much earlier in life than what is normally seen.  

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