medwireNews: Two large cohort studies demonstrated an increased likelihood of being diagnosed with type 2 diabetes in the months following SARS-CoV-2 infection.
Data from both studies come from healthcare databases rather than hospitals, therefore encompassing mild to severe COVID-19, and one shows an increasing risk of diabetes with greater disease severity.
This study, published in The Lancet Diabetes and 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 been diagnosed with diabetes at baseline.
The other study, published in Diabetologyinvolved 35,865 people with 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 with COVID-19 and controls, respectively, which equated to a rate of significantly increased incidence of 1.28.
This increased risk persisted throughout the year and was not observed for other forms of diabetes, report Wolfgang Rathmann (Leibniz Center for Diabetes Research, Heinrich Heine University, Düsseldorf) and co-researchers.
In the US study – by Yan Xie and Ziyad Al-Aly of the VA Saint Louis Health Care System in Missouri – follow-up excluded the first 30 days post-COVID. The 12-month rates of incident diabetes were 48.38 per 1000 people among COVID-19 survivors and 34.93 per 1000 people among controls, giving a significant adjusted risk ratio for diabetes of 1, 40 and an excessive demand of 13.46 per 1000 people.
There was also a significantly increased hazard ratio of 1.85 for newly prescribed antihyperglycemic drugs in people with COVID-19 compared to controls, with an excess demand of 12.35 per 1000 people. These risk increases were seen in categories defined by age, gender, race, BMI, deprivation score, and baseline diabetes risk.
The risk of diabetes was highest among those in need of intensive care for COVID-19, at a rate of 123.48 per 1,000 people, but was significantly elevated even among those who were not hospitalized, at a rate per 1,000. people of 42.70 against 34.42 in controls.
In a comment related to the US study, KM Venkat Narayan and Lisa Staimez, both of the Rollins School of Public Health in Atlanta, Georgia, USA, say that if these results are confirmed, follow-up screening Diabetes should be incorporated into COVID-19 Management Guidelines.
“The long-term implications of increased diabetes risk from SARS-CoV-2 infection are profound,” the commentators write, noting the ever-increasing prevalence of diabetes.
They say that given the large number of COVID-19 cases worldwide, “any increase in the incidence of diabetes related to COVID-19 could result in unprecedented cases of diabetes worldwide, wreaking havoc on systems already overstretched and underfunded public health and clinics around the world, with a devastating toll in terms of death and suffering.
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March 24, 2022: The coronavirus pandemic is affecting all healthcare professionals around the world. The goal of Medicine Matters, in these difficult times, is the dissemination of the latest data to support you in your research and clinical practice, based on the scientific literature. We will update the information we provide on the site as data becomes available. However, please refer to your own professional and government guidelines for the latest guidance in your own country.
Lancet Diabetes Endocrinol 2022; doi:10.1016/S2213-8587(22)00044-4
Diabetology 2022; doi:10.1007/s00125-022-05670-0
Lancet Diabetes Endocrinol 2022; doi:10.1016/S2213-8587(22)00078-X