Study finds increased risk of diabetes diagnosis after COVID-19

• New research links COVID-19 to diabetes diagnoses.
• The researchers found that those vaccinated had a minimal risk of being diagnosed with diabetes again.
• Experts say this bolsters the theory that COVID-19 can cause types of diabetes in some people.

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Scientists are still learning about the fallout from COVID-19, three years after the virus first swept the world. While there are still plenty of unanswered questions, a new study adds to a growing body of research that has found a link between being diagnosed with diabetes shortly after having COVID-19.

The study, which was published in JAMA, analyzed the medical records of more than 23,000 adults who had COVID-19 at least once. The researchers looked at the likelihood of patients developing a new diagnosis of diabetes, high blood pressure, or high cholesterol within three months of contracting the virus, then compared that risk to the three months before COVID. It is important to note that the researchers did not distinguish between types of diabetes, which is a limitation of the study.

The study found that people with COVID-19 had a higher risk of being diagnosed with all three conditions after contracting the virus. However, when they adjusted the data to look at what’s called a gold standard diagnosis (in this case, a new diagnosis of acid reflux or urinary tract infection – two common conditions that aren’t related to COVID or the other conditions), they found that only the risk of developing diabetes was significantly elevated. Again, although the study did not distinguish between different types of diabetes, it did cite that COVID-19 increased the risk of being diagnosed with diabetes by approximately 58%.

It should also be noted that when the study researchers researched which patients had received their COVID-19 vaccine before becoming infected, they found that those who had been vaccinated had only a minimal increased risk of newly diagnosed with diabetes after contracting the virus. With this adjustment, unvaccinated people had an almost 80% higher risk of being newly diagnosed with diabetes.

This is not the first study to link COVID-19 to a new diagnosis of diabetes. A study published last year found that children were 2.5 times more likely to be diagnosed with diabetes after having COVID-19.

Two studies published in the journal Cell metabolism in 2021 also found a link between COVID-19 and a new diagnosis of diabetes. Data published in a letter to the editor in Diabetes, obesity and metabolism: a review of pharmacology and therapeutics in 2021 Also found a link between having the virus and being diagnosed with diabetes.

Although there seems to be a correlation, it’s a bit complicated and scientists don’t have all the answers. Here’s what we know, so far.

Is there a link between COVID-19 and diabetes?

It is important to state at the outset that correlation does not equal causation. This means there may be another reason people are more likely to be newly diagnosed with diabetes after having COVID-19, such as going to the doctor more often. But Thomas Russo, MD, professor and chief of infectious diseases at the University at Buffalo in New York, says the growing body of evidence linking a new diagnosis of diabetes to COVID-19, coupled with the latest findings that vaccination seems make a difference – suggests there might be something to it. “It’s just another piece of evidence that it’s probably real,” he says.

Alan Kwan, MD, lead author of the latest JAMA study and a cardiologist at Cedars Sinai Medical Center, also says he suspects COVID-19 can cause different types of diabetes.
“There have been a few papers now showing this link to diabetes,” he says. “I much more suspect this to be real since we see it in several study populations and designs. We tried to expand on these by looking at whether they continue to hold up through the Omicron era – they do.

There’s a lot to unpack here, says infectious disease expert Amesh A. Adalja, MD, principal investigator at the Johns Hopkins Center for Health Security, including analysis of type 1 diabetes diagnoses versus those type 2. Note: Dr. Kwan explains that his study looked at all types of diabetes, as some medical codes do not specify this, making it difficult to know what to include or exclude when researching diabetes. diabetes diagnoses.

There are some theories about why COVID-19 can lead to various diagnoses of diabetes. “More serious infections are likely to be treated with corticosteroids such as dexamethasone, which can precipitate diabetes,” says Dr Adalja. Some studies indicate that dexamethasone can lead to steroid-induced diabetes, which may or may not go away after a patient stops taking the drug.

COVID-19 itself can target the pancreas, which makes insulin (a hormone that helps regulate your blood sugar), and impact how much insulin your pancreas produces, he says. In fact, laboratory studies have shown that SARS-CoV-2, the virus that causes COVID-19, can infect human beta cells, which are pancreatic cells that make insulin.

Another theory, according to Dr. Kwan: ​​The “robust” inflammation caused by COVID-19 can tip a person who has risk factors for diabetes into actually developing the disease. “Some patients may be pushed over the edge due to physiological stress, but we can’t say for sure,” he says.

Many of the attempts to understand the link between a new diagnosis of diabetes and COVID-19 “fall into the category of trying to understand the long COVID,” says Dr. Russo. “We know that when you get COVID various things can happen,” he says. “You get these microclots, you get prolonged inflammation, and you can develop autoantibodies, which could be a potential cause of type 1 diabetes.”

Ultimately, it’s “unclear why this link exists,” says Dr Russo, adding that “there may be multiple mechanisms.”

So should you get tested for diabetes after having COVID-19?

Dr Russo says “we’re not there yet”. However, he recommends that people who have had COVID-19 be at least aware of the symptoms of diabetes. According to the American Diabetes Association (ADA), these can include:

Type 1 diabetes:

• Urinate often
• be very thirsty
• Being very hungry, even if you are eating
• extreme tiredness
• Blurry vision
• Cuts/bruises slow to heal
• Weight loss, even if you eat more

Type 2 diabetes:

• Urinate often
• be very thirsty
• Being very hungry, even if you are eating
• extreme tiredness
• Blurry vision
• Cuts/bruises slow to heal
• Tingling, pain or numbness in the hands/feet

Dr Adalja says doctors “should think about screening recovered COVID patients for diabetes”, but adds that more data is needed to make a definitive link.

A good way to get your diabetes risk under control, whether or not you’ve had COVID-19, is to see your GP for regular checkups, Dr. Russo says. “They’ll check your blood sugar, as well as a myriad of other things,” he says.

Overall, Dr. Kwan says it’s important to think about this link in the broader context of the pandemic. “At first we thought it was just a respiratory virus,” he says. “We have now seen issues with blood clots, dysfunction of the immune system, and we are now seeing issues with the neurological system and the cardiovascular system. We still do not fully understand all of these effects.

This article is accurate at the time of press. However, as the COVID-19 pandemic rapidly evolves and the scientific community’s understanding of the novel coronavirus grows, some information may have changed since it was last updated. While we aim to keep all of our stories up to date, please visit the online resources provided by the CDC, WHOand your local public health department to stay informed of the latest news. Always consult your physician for professional medical advice.