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Diabetes following SARS-CoV-2 infection: Incidence, persistence, and implications of COVID-19 vaccination. A cohort study of fifteen million people.

Discussion in ''Conditions related to ME/CFS' news and research' started by EndME, Aug 11, 2023.

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  1. EndME

    EndME Senior Member (Voting Rights)

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    1,199
    Diabetes following SARS-CoV-2 infection: Incidence, persistence, and implications of COVID-19 vaccination. A cohort study of fifteen million people.


    Background
    Type 2 diabetes (T2DM) incidence is increased after diagnosis of COVID-19. The impact of vaccination on this increase, for how long it persists, and the effect of COVID-19 on other types of diabetes remain unclear.

    Methods
    With NHS England approval, we studied diabetes incidence following COVID-19 diagnosis in pre-vaccination (N=15,211,471, January 2020-December 2021), vaccinated (N =11,822,640), and unvaccinated (N=2,851,183) cohorts (June-December 2021), using linked electronic health records.We estimated adjusted hazard ratios (aHRs) comparing diabetes incidence post-COVID-19 diagnosis with incidence before or without diagnosis up to 102 weeks post-diagnosis. Results were stratified by COVID-19 severity (hospitalised/non-hospitalised) and diabetes type.

    Findings
    In the pre-vaccination cohort, aHRS for T2DM incidence after COVID-19 (compared to before or without diagnosis) declined from 3.01 (95% CI: 2.76,3.28) in weeks 1-4 to 1.24 (1.12,1.38) in weeks 53-102. aHRS were higher in unvaccinated than vaccinated people (4.86 (3.69,6.41)) versus 1.42 (1.24,1.62) in weeks 1-4) and for hospitalised COVID-19 (pre-vaccination cohort 21.1 (18.8,23.7) in weeks 1-4 declining to 2.04 (1.65,2.51) in weeks 52-102), than non-hospitalised COVID-19 (1.45 (1.27,1.64) in weeks 1-4, 1.10 (0.98,1.23) in weeks 52-102). T2DM persisted for 4 months after COVID-19 for ~73% of those diagnosed. Patterns were similar for Type 1 diabetes, though excess incidence did not persist beyond a year post-COVID-19.

    Interpretation
    Elevated T2DM incidence after COVID-19 is greater, and persists longer, in hospitalised than non-hospitalised people. It is markedly less apparent post-vaccination. Testing for T2DM after severe COVID-19 and promotion of vaccination are important tools in addressing this public health problem.



    https://www.medrxiv.org/content/10.1101/2023.08.07.23293778v1
     
    EndME, Aug 11, 2023
    #1
    RedFox, Hutan, Trish and 1 other person like this.
  2. Midnattsol

    Midnattsol Moderator Staff Member

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    What makes it so hard is that diabetes has been on the rise for a long while already, and even pre-covid it was set to double by 2050.

    Edit: Not talking about individual countries here, increasing pwDiabetes is a global health issue.
     
    Midnattsol, Aug 11, 2023
    #2
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  3. Hutan

    Hutan Moderator Staff Member

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    Aotearoa New Zealand
    I wonder too what influence weeks of lockdown had on the appearance of diabetes in people who might have been hovering close to the line. Comfort eating, home baking experiments, less active days, elastic waisted track suit pants not sending the message clearly that weight was being put on.

    Also, people who are vaccinated versus unvaccinated probably, on average, differ in ways other than whether they were vaccinated. I don't think we should automatically assume that the vaccination was protective.

    (I haven't read the paper.)
     
    Hutan, Aug 11, 2023
    #3
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  4. Midnattsol

    Midnattsol Moderator Staff Member

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    3,768
    But we also saw people who became more active, had more time to make "healthy homemade meals" and increased their sleep, all factors that could improve metabolic health. I'm not sure if the number of people on the verge of getting full-blown diabetes who ate more comfort foods and became less active are in the majority, at least not enough of them to make an impact in population studies.

    Though I feel looking at hospitalised patients is going to skew the data given that diabetes is a risk factor for more severe covid. There could be many who had undiagnosed diabetes pre-covid and ths was discovered during hospitalisation. And probably patients on the verge of getting diabetes also has increased risk for hospitalisation, and again higher risk of developing diabetes in general.

    Agree, but this could go either way. There are plenty of the anti-vax crowd that are all about natural whole foods, being outdoors and working out.. It's been quite frustrating to see people I've thought of as science literate suddenly reveal themselves as anti-vaccine and just really doubling down on a healthy diet being a cure-all.

    I've lost several resources I previously felt able to share with others on diet, as now the websites also contain a lot of misinformation on covid and vaccine development.

    Me neither :whistle:
     
    Midnattsol, Aug 11, 2023
    #4
    Sean, EndME, NelliePledge and 3 others like this.

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