Can COVID-19 Cause Diabetes? New Study Finds an Alarming Correlation
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New research finds a link between COVID-19 and diabetes diagnoses.
Researchers discovered that people who were vaccinated had a minimal risk of a new diabetes diagnosis.
Experts say this strengthens the theory that COVID-19 may cause types of diabetes in some people.
Scientists are still learning about the fallout from COVID-19, three years after the virus first swept the globe. While there are a lot of questions still unanswered, a new study is adding to a growing body of research that has found a link between being diagnosed with diabetes soon after having COVID-19.
The study, which was published in JAMA, analyzed the medical records of more than 23,000 adults who had COVID-19 at least once. The researchers looked at how likely patients were to develop a new diagnosis of diabetes, high blood pressure, or high cholesterol within three months after having the virus, and then compared that risk to the three months before they got COVID. It’s important to note that researchers did not distinguish between types of diabetes, which is a limitation of the study.
The study found that people who had COVID-19 had a higher risk of being diagnosed with all three conditions after having the virus. However, when they adjusted the data to look at something called a benchmark diagnosis (in this case, a new diagnosis of acid reflux or a UTI—two common conditions that aren’t related to COVID or the other conditions), they found that only the risk of developing diabetes was significantly elevated. Again, while the study did not distinguish between the various types of diabetes, they did in fact cite that COVID-19 raised the risk of being diagnosed with diabetes by about 58%.
It’s also worth noting that when the study’s researchers drilled down on which patients had gotten their COVID-19 vaccine before becoming infected, they found that those who had been vaccinated had only a minimal increased risk of a new diabetes diagnosis after having the virus. With this adjustment, people who were unvaccinated had a nearly 80% greater risk of a new diabetes diagnosis.
This isn’t the first study to connect COVID-19 with a new diabetes diagnosis. One study published last year found that children were 2.5 times more likely to be diagnosed with diabetes after having COVID-19.
Two studies published in the journal Cell Metabolism in 2021 also found a link between COVID-19 and a new diabetes diagnosis. Data published in a letter to the editor in Diabetes, Obesity, and Metabolism: A Journal of Pharmacology and Therapeutics in 2021 also found a connection between having the virus and being diagnosed with diabetes.
While there seems to be a correlation, it’s a little complicated—and scientists don’t have all the answers. Here’s what we know, as of now.
Is there a link between COVID-19 and diabetes?
It’s important to state upfront that correlation doesn’t equal causation. Meaning, there may be some other reason why people are more likely to receive a new diabetes diagnosis after having COVID-19, like going to the doctor’s office more. But Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York, says the growing body of evidence that links a new diabetes diagnosis to COVID-19—coupled with the latest findings that vaccination seems to make a difference—suggests there could be something to this. “This is just another piece of evidence that this is likely a reality,” he says.
Alan Kwan, M.D., lead study author of the latest JAMA study and a cardiologist at Cedars Sinai Medical Center, also says he suspects COVID-19 may cause different types of diabetes.
“There have been a few papers now showing this diabetes connection,” he says. “I have a much higher suspicion for this being real since we’re seeing it in multiple populations and study designs. We tried to expand on those by looking at whether it continues to hold during the Omicron era—it does.”
There’s a lot that needs to be unpacked here, says infectious disease expert Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security, including parsing out type 1 vs. type 2 diabetes diagnoses. A note: Dr. Kwan says his study looked at all types of diabetes because some medical codes don’t specify, making it hard to know what to include or exclude when searching for diabetes diagnoses.
There are some theories on why COVID-19 may lead to various diabetes diagnoses. “More severe infections are likely to be treated with corticosteroids such as dexamethasone, which can precipitate diabetes,” Dr. Adalja says. Some studies indicate that dexamethasone can lead to steroid-induced diabetes, which may or may not go away after a patient stops taking the medication.
COVID-19 itself can target the pancreas, which makes insulin (a hormone that helps regulate your blood sugar), and impact how much insulin your pancreas produces, he says. In fact, lab studies have shown that SARS-CoV-2, the virus that causes COVID-19, can infect human beta cells, which are the pancreatic cells that make insulin.
Another theory, per Dr. Kwan: The “robust” inflammation that COVID-19 causes can tip someone who has risk factors for diabetes into actually developing the disease. “It may be that some patients are pushed over the edge based on the physiological stress—but we can’t say for sure,” he says.
A lot of trying to understand the link between a new diabetes diagnosis and COVID-19 “falls into the category of trying to understand long COVID,” Dr. Russo says. “We know when you get COVID, a variety of things can happen,” he says. “You get these microclots, you get prolonged inflammation, and you can develop auto-antibodies—that could be a potential cause of type 1 diabetes.”
Ultimately, the reason why this link exists is “unclear,” Dr. Russo says, adding, “there may be multiple mechanisms.”
So, should you get tested for diabetes after having COVID-19?
Dr. Russo says “we’re not there yet.” However, he recommends that people who have had COVID-19 at least be aware of the symptoms of diabetes. According to the American Diabetes Association (ADA), those can include:
Urinating often
Feeling very thirsty
Feeling very hungry—even though you are eating
Extreme fatigue
Blurry vision
Cuts/bruises that are slow to heal
Weight loss—even though you are eating more
Urinating often
Feeling very thirsty
Feeling very hungry—even though you are eating
Extreme fatigue
Blurry vision
Cuts/bruises that are slow to heal
Tingling, pain, or numbness in the hands/feet
Dr. Adalja says that doctors “should think about diabetes screening in recovered COVID patients,” but adds that more data is needed to establish a definite link.
One good way to stay on top of your diabetes risk, whether you’ve had COVID-19 or not, is to see your primary care physician for regular checkups, Dr. Russo says. “They will check your blood sugar, along with myriad other things,” he says.
Overall, Dr. Kwan says that it’s important to think about this connection in the broader context of the pandemic. “At the beginning, we thought this was just a respiratory virus,” he says. “We’ve now observed issues with blood clots, dysfunction of the immune system, and we’re now seeing problems with the neurological system and cardiovascular system. We still don’t fully understand the totality of these effects.”
This article is accurate as of press time. However, as the COVID-19 pandemic rapidly evolves and the scientific community’s understanding of the novel coronavirus develops, some of the information may have changed since it was last updated. While we aim to keep all of our stories up to date, please visit online resources provided by the CDC, WHO, and your local public health department to stay informed on the latest news. Always talk to your doctor for professional medical advice.
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