Risk for new-onset diabetes appears to have increased during COVID-19 pandemic
While the pandemic period was associated with more new cases of type 2 diabetes across subgroups, risk was highest among patients exposed to SARS-CoV-2, a cohort study in Florida found.
Risk for new-onset type 2 diabetes appears to have increased during the COVID-19 pandemic, a recent study found.
Researchers conducted a retrospective cohort study of electronic health record data from patients in Florida to evaluate the risk of new-onset diabetes after SARS-CoV-2 infection in a sociodemographically diverse sample. Study participants were divided into those who had a positive SARS-CoV-2 test or COVID-19 diagnosis between March 2020 and January 2022 (n=43,906), an unexposed cohort with a negative SARS-CoV-2 test (n=162,683), or an age- and sex-matched historical control cohort with index visits between March 2018 and January 2020 (n=40,957). The primary outcome was new-onset type 2 diabetes 30 days or more after the index visit. Results were published Sept. 20 by Journal of General Internal Medicine.
Sixty-two percent of patients were female, 21.4% were non-Hispanic Black, and 21.4% were Hispanic. Compared with historical controls, risk for new-onset diabetes was higher among both the unexposed and exposed cohorts (hazard ratios, 1.28 [95% CI, 1.18 to 1.39] and 1.64 [95% CI, 1.50 to 1.80], respectively), but the latter had a higher risk than the former (hazard ratio, 1.28 [95% CI, 1.19 to 1.37]). Higher risk among the exposed and unexposed cohorts relative to the historical cohort persisted across all sociodemographic subgroups and did not vary by whether patients were hospitalized or not. Patients who had a positive test for COVID-19 were more likely to be younger and female, to belong to a minority racial/ethnic group, and to have a higher body mass index than those who tested negative.
The researchers concluded that patients who sought care during the pandemic period and tested positive for SARS-CoV-2 infection had the highest risk of new-onset diabetes versus those who tested negative and historical controls, noting that these associations were also observed among younger adults and racial and ethnic minorities who have been disproportionately impacted by COVID-19.
“Although the observed association between SARS-CoV-2 and T2DM [type 2 diabetes], if causal, may be mediated through viral pathways, current observational studies cannot rule out alternative explanations such as higher T2DM risk or undiagnosed T2DM before infection and changes in healthcare utilization after infection leading to a higher likelihood of diagnosis,” the researchers wrote. “Given these uncertainties, it is unclear if the observed increased risk of T2DM among patients testing positive for SARS-CoV-2 portends a major shift in diabetes incidence in the USA.”