SARS-CoV-2 linked to higher risk of diabetes

According to results published in Open JAMA Network.

Credit: Jerome Cronenberger – stock.adobe.com

In addition to other long-term morbidity issues, emerging evidence suggests that COVID-19 may be associated with changes in the pathophysiology of diabetes. Notably, diabetes has already been established as a risk factor for more severe COVID-19-related respiratory outcomes, and SARS-CoV-2 infection is associated with worsening of pre-existing diabetes symptoms.

However, experts have not established whether SARS-CoV-2 infection is associated with transient hyperglycemia during active infection or whether metabolic alterations persist. Current data on this issue is sparse, and most published studies have been conducted with relatively small sample sizes or have limitations due to participant selection or outcome determination. Studies to date have primarily identified a low but higher rate of incident diabetes in people with COVID-19 compared to those without COVID-19.

To improve understanding of this association, the researchers conducted a large-scale, population-based cohort study using population-based registers and datasets. The study used data from the British Columbia COVID-19 Cohort, including data on medical visits, hospitalizations, emergency department visits, prescription drug dispensations, chronic conditions and vital statistics.

Eligible adult participants who tested positive for SARS-CoV-2 were matched by gender, age and date of reverse transcription polymerase chain reaction (RT-PCR) test collection according to a report of 1:4 with people who tested negative. After initial matching of exposure groups and people with prevalent diabetes or in long-term care facilities were excluded, the analytical sample consisted of 125,987 exposed and 503,948 unexposed people.

Study participants were followed for a median of 257 days. During this period, incident diabetes events were recorded in 2472 individuals (0.4%), including 608 exposed (0.5%) and 1864 unexposed (0.4%). Of those diagnosed with incidence diabetes, 56.4% were female and 43.65% were male.

The incidence rate of diabetes per 100,000 person-years was significantly higher in the exposed group than in the unexposed group (incidence of 672.2 versus 508.7 incidents). The risk of incident diabetes was also significantly higher in men and in those with more severe SARS-CoV-2 disease.

These findings suggest that COVID-19 infection may continue to be associated with outcomes in organ systems involved in regulating blood glucose and may have contributed to the 3% to 5% of excess incident diabetes cases found in the ‘study. At the population level, SARS-CoV-2 infection may also be associated with a higher burden of diabetes.

The authors noted that the main strength of their study was the comprehensive population-based capture of SARS-CoV-2 infection and the integration of this data with population-based registries and databases on health care utilization to identify incident diabetes and potential confounders. Additionally, compared to most previous studies, this research had a longer follow-up time, allowing investigation of the risk of diabetes as a long-term sequela of COVID-19.

REFERENCE

Naveed Z, Garcia HAV, Wong S, et al. Association of COVID-19 infection with incident diabetes. JAMA Netw Open. 2023;6(4):e238866. doi:10.1001/jamanetworkopen.2023.8866