Objective: The COVID-19 pandemic has evolved over time by SARS-CoV-2 variant, disease severity, treatment and prevention. There is evidence of elevated risk of incident diabetes after COVID-19; our objective was to evaluate whether this association is consistent across time and with contemporary viral variants.
Research Design and Methods: We conducted a retrospective cohort study using National COVID Cohort Collaborative data to evaluate incident diabetes risk among COVID positive adults compared to COVID negative patients or controls with acute respiratory illness (ARI). Cohorts were weighted on demographics, data site, and Charlson Comorbidity Index score. The primary outcome was the cumulative incidence ratio (CIR) of incident diabetes for each viral variant era.
Results: Risk of incident diabetes one year after COVID-19 was increased for all viral variants compared to COVID negative (Ancestral CIR 1.16, 95% CI 1.12-1.21, Alpha CIR 1.14, 95% CI 1.11-1.17, Delta CIR 1.17, 95% CI 1.13-1.21 , Omicron CIR 1.13, 95% CI 1.10-1.17) and ARI controls (Ancestral CIR 1.17, 95% CI 1.11-1.22, Alpha CIR 1.14, 95% CI 1.09-1.19, Delta CIR 1.18, 95% CI 1.11-1.26, Omicron CIR 1.20, 95% CI 1.13-1.27). There was latency in the timing of incident diabetes risk with the Omicron variant; in contrast to other variants, the risk presented after 180 days.
Conclusions: Incident diabetes risk after COVID-19 was similar across different SARS-CoV-2 variants. However, there was greater latency in diabetes onset in the Omicron variant era.
Funding
R.W., J.R., S.J. and H.Y. receive funding by 3R01DK130351-02S1, National Institutes of Health (NIH). C.B. is funded by the National Institute of Digestive, Diabetes, and Kidney Diseases K23DK124654. T.S. receives investigator-initiated research funding and support as Principal Investigator (R01AG056479) from the National Institute on Aging (NIA), and as Co-Investigator (R01CA277756) from the National Cancer Institute, National Institutes of Health (NIH). He also receives salary support as Director of Comparative Effectiveness Research (CER), NC TraCS Institute, UNC Clinical and Translational Science Award (UM1TR004406), co-Director of the Human Studies Consultation Core, NC Diabetes Research Center (P30DK124723), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the Center for Pharmacoepidemiology (current members: GlaxoSmithKline, UCB BioSciences, Takeda, AbbVie, Boehringer Ingelheim, Astellas, and Sarepta), and from a generous contribution from Dr. Nancy A. Dreyer to the Department of Epidemiology, University of North Carolina at Chapel Hill for non-related work. Dr. Stürmer does not accept personal compensation of any kind from any pharmaceutical company. He owns stock in Novartis, Roche, and Novo Nordisk. J.B.B. was supported by grants from the NIH (UL1TR002489, UM1TR004406). He has also received grant support from Bayer, Boehringer-Ingelheim, Carmot, Corcept, Dexcom, Eli Lilly, Insulet, MannKind, Novo Nordisk, and vTv Therapeutics; consulting contracts from Alkahest, Altimmune, Anji, Aqua Medical Inc, AstraZeneca, Boehringer-Ingelheim, CeQur, Corcept Therapeutics, Dasman Diabetes Center (Kuwait), Eli Lilly, embecta, Fortress Biotech, GentiBio, Glyscend, Insulet, Mediflix, Medscape, Mellitus Health, Metsera, Moderna, Novo Nordisk, Pendulum Therapeutics, Praetego, ReachMD, Stability Health, Tandem, Terns Inc, and Vertex; expert witness engagement by Medtronic MiniMed; and stock options from Glyscend, Mellitus Health, Pendulum Therapeutics
