Diabetes Obes Metab. 2026 May 10. doi: 10.1111/dom.70856. Online ahead of print.
ABSTRACT
AIMS: Evidence suggests that COVID-19 may be associated with an increased risk of diabetes. We aimed to examine this association by investigating the role of socioeconomic and metabolic factors on the risk of new-onset type 2 (T2D) and type 1 (T1D) diabetes after COVID-19 diagnosis.
MATERIALS AND METHODS: We conducted a retrospective, population-based cohort study using linked electronic health records from NHS England’s Secure Data Environment for England via the CVD-COVID-UK/COVID-IMPACT consortium. Adults (≥ 18 years), alive, registered with a general practice within 1 January 2020 and 28 May 2024 were included. Exposed individuals with confirmed COVID-19 diagnosis and no prior diabetes were matched to up to three unexposed individuals without COVID-19 and diabetes on age, sex, region and deprivation. Flexible parametric survival models were used to estimate associations between COVID-19 and incident diabetes by sex and across age, BMI, deprivation, ethnicity, and region.
RESULTS: Of 50 156 810 eligible individuals, 12 859 545 with a COVID-19 diagnosis and no prior diabetes were matched to 29 221 285 without COVID-19; the median follow-up was 2.4 years. Although BMI was strongly and positively associated with the risk of T2D, differences between exposed and unexposed individuals were little to none, with the excess risk concentrated in the first year (e.g., in 70-year-old men with BMI 35 kg/m2, rates were 44.2 [95% CI: 43.6-44.8] and 44.2 [43.7-44.8] per 1000 person-years in the exposed and unexposed group, respectively, at 1 year; corresponding figures in women were 28.0 [27.6-28.5] and 29.1 [28.7-29.5]). These rate differences by COVID-19 exposure were considerably smaller than those across BMI levels: for example, 22 more T2D cases per 1000 person-years at 1 year for those with a BMI of 35 versus 30 kg/m2 in unexposed 70-year-old men. Similarly, higher deprivation and Asian ethnicity were also more strongly associated with the risk of T2D than COVID-19 exposure. There was no evidence of an association between COVID-19 and T1D across all analyses.
CONCLUSIONS: In this cohort, COVID-19 was associated with a modest, short-term increase in T2D risk and showed no meaningful association with T1D. Established metabolic, demographic and socioeconomic factors-including age, BMI, deprivation and ethnicity-were more strongly associated with T2D incidence than COVID-19 exposure.
PMID:42108424 | DOI:10.1111/dom.70856
