ORCID
- Wei, Yinghui: 0000-0002-7873-0009
Abstract
Background Some studies have shown that the incidence of type 2 diabetes increases after a diagnosis of COVID-19,although the evidence is not conclusive. However, the effects of the COVID-19 vaccine on this association, or theeffect on other diabetes subtypes, are not clear. We aimed to investigate the association between COVID-19 andincidence of type 2, type 1, gestational and non-specific diabetes, and the effect of COVID- 19 vaccination, up to52 weeks after diagnosis.Methods In this retrospective cohort study, we investigated the diagnoses of incident diabetes following COVID-19diagnosis in England in a pre-vaccination, vaccinated, and unvaccinated cohort using linked electronic health records.People alive and aged between 18 years and 110 years, registered with a general practitioner for at least 6 months beforebaseline, and with available data for sex, region, and area deprivation were included. Those with a previous COVID-19diagnosis were excluded. We estimated adjusted hazard ratios (aHRs) comparing diabetes incidence afterCOVID-19 diagnosis with diabetes incidence before or in the absence of COVID-19 up to 102 weeks after diagnosis.Results were stratified by COVID-19 severity (categorised as hospitalised or non-hospitalised) and diabetes type.Findings 16669 943 people were included in the pre-vaccination cohort (Jan 1, 2020–Dec 14, 2021), 12279669 in thevaccinated cohort, and 3 076953 in the unvaccinated cohort (both June 1–Dec 14, 2021). In the pre-vaccination cohort,aHRs for the incidence of type 2 diabetes after COVID-19 (compared with before or in the absence of diagnosis)declined from 4·30 (95% CI 4·06–4·55) in weeks 1–4 to 1·24 (1·14–1.35) in weeks 53–102. aHRs were higher in unvaccinated people (8·76 [7·49–10·25]) than in vaccinated people (1·66 [1·50–1·84]) in weeks 1–4 and in patientshospitalised with COVID-19 (pre-vaccination cohort 28·3 [26·2–30·5]) in weeks 1–4 declining to 2·04 [1·72–2·42] in weeks 53–102) than in those who were not hospitalised (1·95 [1·78–2·13] in weeks 1–4 declining to 1·11 [1·01–1·22]in weeks 53–102). Type 2 diabetes persisted for 4 months after COVID-19 in around 60% of those diagnosed. Patterns were similar for type 1 diabetes, although excess incidence did not persist beyond 1 year after a COVID-19 diagnosis.Interpretation Elevated incidence of type 2 diabetes after COVID-19 is greater, and persists for longer, in people whowere hospitalised with COVID-19 than in those who were not, and is markedly less apparent in people who have beenvaccinated against COVID-19. Testing for type 2 diabetes after severe COVID-19 and the promotion of vaccination areimportant tools in addressing this public health problem.
DOI
10.1016/S2213-8587(24)00159-1
Publication Date
2024-08-01
Publication Title
The Lancet Diabetes and Endocrinology
Volume
12
Issue
8
ISSN
2213-8587
Organisational Unit
School of Engineering, Computing and Mathematics
Recommended Citation
Taylor, K., Eastwood, S., Walker, V., Cezard, G., Knight, R., Arab, M., Wei, Y., Horne, E., Teece, L., Forbes, H., Walker, A., Fisher, L., Massey, J., Hopcraft, L., Palmer, T., Cuitun coronado, J., Ip, S., Davy, S., Dillingham, I., Morton, C., Greaves, F., Macleod, J., Goldacre, B., Wood, A., Chaturvedi, N., Sterne, J., & Denholm, R. (2024) 'Incidence of diabetes after SARS-CoV-2 infection in England and the implications of COVID-19 vaccination: a retrospective cohort study of 16 million people', The Lancet Diabetes and Endocrinology, 12(8). Available at: https://doi.org/10.1016/S2213-8587(24)00159-1
