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During the COVID-19 pandemic, the elevated risk of infection for individuals with pre-existing conditions was emphasized. However, scientific research gradually revealed that this new coronavirus not only induced more severe clinical presentations in patients with pre-existing conditions, but that it could itself be a risk factor for several chronic conditions.

In this area of research, a new meta-analysis, Risk of incident diabetes after COVID-19 infection: A systematic review and meta-analysis, set out to evaluate the connection between COVID-19 and incident diabetes by reviewing the existing evidence.

The highlights of the review include:

• Eleven cohorts involving a total of 47.1 million participants, mainly from the United States and Europe, were included.
• The studies analyzed were extracted from Embase, PubMed, CENTRAL, and databases from scientific platforms, between December 2019 and June 2022. Among other things, these studies had in common that they provided an individual’s relative risk of diabetes after confirming the diagnosis of COVID.
• A 64% greater risk of diabetes was found in patients with COVID-19.
• This could increase the number of diabetes events by 701 per 10,000 people.
• A significant association was found for both type 1 and type 2 diabetes, although there was a higher relative risk for type 2 diabetes.
• In general, men were at a higher risk of diabetes than women.

The term Post-Acute Sequelae of CoV-2 (PASC) is a clinical label for those with symptoms after COVID-19, although the popular term “long COVID” is often used interchangeably. In addition to symptoms such as chronic fatigue and respiratory disorders, the scientists observed another clinical phenomenon: the appearance of metabolic dysfunction after being exposed to the virus and developing the infection. This began to be detected in previously healthy individuals without a diagnosis of diabetes.

The evidence suggests a bidirectional relationship between diabetes and COVID-19. Both pre-existing diabetes and new-onset post-infection diabetes are important factors in raising the risk of severe adverse outcomes (for example, acute respiratory distress syndrome, intensive care unit admission, use of mechanical ventilation, death) in patients with COVID-19.

Meanwhile, a greater incidence of diabetes has been reported in patients following a diagnosis of COVID-19. Both type 1 diabetes (T1D) and type 2 diabetes (T2D) can be induced by COVID-19, although the underlying mechanisms have not yet been fully explored. 

This highlights the enormous importance of raising awareness of diabetes risk among COVID-19 patients and of identifying potential factors that influence risk.

New-onset diabetes after COVID-19 is an increasingly important new public health problem, as the pandemic continues and new strains of the coronavirus continue to emerge. Given the limited but promising evidence suggesting worse complications in patients with comorbid diabetes, interventions should be carried out to prevent and control this comorbidity.

The magnitude of the apparent effect of COVID-19 on diabetes outcomes echoes the incidence of diabetes in COVID-19 patients, which has been reported or summarized in previous studies. Furthermore, differences in relative risk and absolute risk, based on comparisons between people with and without COVID-19, could better describe the adverse effects of COVID-19 on diabetes. 

Although the incidence of T1D is relatively low, an earlier review found a potentially strong association between the incidence of COVID-19 and T1D.

For T2D, risk estimates and 95% confidence intervals for all included cohorts indicated a statistically significantly increased risk. 

The World Health Organization (WHO) indicates that globally, 422 million people between ages 20 and 79 are living with diabetes. The forecast is for 643 million people by 2030. Three out of every four people with diabetes live in low- and middle-income countries. 

In 2019, 1.4 million new cases of diabetes were diagnosed in adults in the United States. 

In Latin America and the Caribbean, 62 million people are living with diabetes. A comparison of data from 2000 and 2019 shows that people in the Americas spend nearly twice as many years of life suffering from the debilitating effects and complications of diabetes, compared to figures from two decades ago.

This story was produced using content from the original study and from other medical research, as well as health and public health sources, highlighted in related links throughout the article.