COVID-19 is associated with a 3% to 5% increase in diabetes incidence

COVID-19 infection is associated with a significantly increased risk of: DiabetesAccording to a study published in , it may have contributed to a 3% to 5% overburden of diabetes at the population level. JAMA network open.

The study authors also found that men had a higher risk of diabetes than women, and that there was a higher risk of diabetes among those with severe disease compared to those without COVID-19. .

“These findings suggest that COVID-19 infection may continue to be associated with outcomes in organ systems involved in glycemic regulation after the acute phase, with the excess It may contribute to 3% to 5% of diabetes cases,” the authors wrote.

A population-based cohort study was conducted from 1 January 2020 to 31 December 2021 in British Columbia, Canada. Registry and management data sets.

This study included a total of 629,935 individuals who were tested for SARS-CoV-2 using real-time reverse transcription-polymerase chain reaction (RT-PCR). SARS-CoV-2 positive (exposed) and negative (non-exposed) individuals were matched in a 1:4 ratio based on sex, age, and RT-PCR test collection date. Analysis was conducted from 14 January 2022 to 19 January 2023.

The primary objective of this study was to identify cases of diabetes that occurred more than 30 days after the date of specimen collection for SARS-CoV-2 testing. Identification was performed using validated algorithms based on hospital visits, hospitalization records, chronic disease registries, and prescription medications for diabetes management.

Among the full cohort, the median age (IQR) was 32 (25.0-42.0) years and 51.2% of the cohort were female. Of this group, 125,987 were exposed to her SARS-CoV-2 and 503,948 were not.

With a median (IQR) follow-up of 257 (102-356) days, development of diabetes was observed in 608 (0.5%) exposed and 1864 (0.4%) unexposed individuals.

Diabetes incidence per 100,000 person-years was 672.2 (95% CI, 618.7–725.6) in the exposed group and 508.7 (95% CI, 485.6–531.8) in the unexposed group.

The risk of developing diabetes was 17% higher in the exposed group than in the unexposed group (HR 1.17; 95% CI 1.06-1.28) and 22% higher in men than in women (adjusted HR 1.22; 95% CI, 1.06- 1.40). Intensive care unit (ICU) (HR, 3.29; 95% CI, 1.98-5.48) or hospital (HR, 2.42; 95% CI, 1.87-3.15).

According to the authors, the overall incidence of diabetes attributable to SARS-CoV-2 infection was 3.41% (95% CI, 1.20%-5.61%) and 4.75% (95% CI, 1.30%-8.20%). bottom. male.

According to the authors, this may be due to sex-specific immune responses, such as higher serum concentrations of SARS-CoV-2 IgG antibodies in female patients compared to male patients. However, when restricting the sample to her COVID-19 hospitalization and her ICU admissions, the authors found not only a greater increase in risk in the severely ill group, but also a significant increase in both male and female patients. I also observed that there is a correlation. These findings are consistent with previous studies reporting mixed results.

Although the overall results were consistent with some previous studies that identified an increased risk of developing diabetes after SARS-CoV-2 infection, the actual increased risk was higher in this compared to other analyses. analysis was low.

One study, using the U.S. Department of Veterans Affairs (VA) national database, found that COVID-19 survivors who survived for at least 30 days had a greater than median risk of developing diabetes compared with individuals in the control group. found to be 40% higher. 352 days follow-up (HR, 1.40; 95% CI, 1.36-1.44). It should be noted, however, that the VA population in that study was predominantly male and had a higher median age, whereas the current study population was more diverse in terms of age and sex. There are also differences in racial and ethnic representation with the current study population, as well as differences in the prevalence of overweight and obesity in the US population, which may affect our findings.

Distinguishing between diabetes types (insulin-dependent and non-insulin dependent), COVID-19 was associated only with non-insulin dependent disease.

“However, the small number of insulin-dependent diabetic events in our sample may be limiting,” the authors say. Given that it was classified into type 2, a definitive comparison cannot be made. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) code.

Limitations of this study include potential residual confounding by unmeasured covariates such as obesity status and physical activity level, as well as possible surveillance bias and incomplete description of access and use of health care. . Additionally, misclassification of COVID-19 exposure and false-negative results may have influenced the results.

“Our study will help health organizations and clinicians to recognize the potential long-term effects of COVID-19 and monitor people for timely diagnosis and treatment of new-onset diabetes after COVID-19 infection. emphasizes the importance of doing,” the authors conclude.

reference

Naveed Z, Velásquez García HA, Wong S, et al. Association between COVID-19 infection and diabetes. JAMA net openPublished online April 18, 2023. doi:10.1001/jamanetworkopen.2023.8866