COVID-19 increases the risk for new-onset diabetes, even during the current phase dominated by Omicron variants, according to a research letter published in JAMA Network Open.

Researchers studied whether the risks for cardiometabolic disease that were noted in the early phases of COVID-19 continued to persist in the current state dominated by less virulent Omicron variants. They also reviewed the odds of a new cardiometabolic diagnosis 90 days after, versus 90 days before, COVID-19 infection. The odds of new cardiometabolic diagnoses were compared with those of a new benchmark diagnosis (urinary tract infection and gastroesophageal reflux) to account for disruptions in health care use during the pandemic.

The researchers found that the rates of new-onset diabetes, hypertension, hyperlipidemia, and benchmark diagnoses were higher in the 90 days after versus before a COVID-19 infection. Post-infection, the highest odds were seen for diabetes, hypertension, benchmark diagnoses, and hyperlipidemia.

The risk for new-onset diabetes occurring after a COVID-19 infection (versus before) was significantly elevated compared with benchmark diagnoses in adjusted multivariable models, but no increase was seen in the risks for hypertension and hyperlipidemia. The risk for diabetes after COVID-19 was higher among unvaccinated patients, but the interaction between vaccination status and a diabetes diagnosis was not significant.

The authors noted that while the mechanisms contributing to diabetes after a COVID-19 infection were unclear, persistent inflammation contributing to insulin resistance could be the pathway.

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