Incidence of diabetes following COVID-19 vaccination and SAR

Incidence of diabetes following COVID-19 vaccination and SARS-CoV-2 infection in Hong Kong: A population-based cohort study

Author summary Why was this study done? There have been an increasing number of cases of type 1 diabetes reported following Coronavirus Disease 2019 (COVID-19) vaccinations. The relationship between receiving COVID-19 vaccines and incident diabetes has not been examined in population-based studies. Several nationwide cohorts reported higher risks of incident diabetes following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. The risk of incident diabetes following infection by SARS-CoV-2 Omicron variants may differ from that following infection by earlier variants. It is also uncertain how vaccination status may influence the risk. What did the researchers do and find? This study included 167,337 CoronaVac, 158,378 BNT162b2 recipients, and 145,199 COVID-19 patients with their respective 1:1 matched control. There was no evidence of increased risks of incident diabetes following COVID-19 vaccination. Regardless of predominant circulating variants, SARS-CoV-2 infection was associated with significantly higher risks of incident diabetes, particularly type 2 diabetes. However, these risks were lower with Omicron variants. Fully vaccinated COVID-19 survivors did not have an increased risk of incident diabetes. What do these findings mean? There is still an increased risk of incident diabetes following SARS-CoV-2 infection even with the prevailing Omicron variants, although the risk is lower. Fully vaccinated individuals might be protected from the risk of incident diabetes following SARS-CoV-2 infection. As there was no evidence of increased risks of incident diabetes following COVID-19 vaccination, our results encourage people to get fully vaccinated to protect themselves from severe complications of COVID-19 and the sequelae of long COVID, including the potential risk of incident diabetes. Causal interpretation of these findings is limited by potential misclassification bias as type 1 diabetes was identified through diagnostic coding and possible residual confounders.

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