Risk of Incident Diabetes after COVID-19 Infection

Coronavirus disease 2019 (COVID-19) is one of the most significant pandemics in human history caused by the virus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 has infected >530 million people, of which >6.3 million have died since June 23, 2022.

Recent research has indicated that COVID-19 might be a risk factor for various chronic diseases, which means new health problems will be added to the already tough ones. 

Both pre-existing diabetes and new-onset diabetes after infection are important factors in increasing the risk of serious adverse outcomes (e.g. acute respiratory distress syndrome, intensive care unit admission, mechanical ventilation use, death) in patients with COVID-19.

Increased incidence of diabetes has been reported in patients following a COVID-19 diagnosis. Both type 1 diabetes (T1D) and type 2 diabetes (T2D) may be induced by COVID-19, although the underlying mechanisms have not been fully explored.


This systematic review and meta-analysis sought to determine the relative risk of incident diabetes in patients with COVID-19.

Based on 11 retrospective cohorts involving 47,120,129 participants, primarily from the United States and Europe, authors found that COVID-19 was associated with a 64 % increased risk of overall diabetes.

The magnitude of the effect of COVID-19 on T2D was significantly greater than that on T1D. The risk was also consistent compared with the historical controls and respiratory infection controls.

There was a 64% greater risk of diabetes in patients with COVID-19 compared with non-COVID controls.

The relative risk of type 2 diabetes was higher than that of type 1 diabetes. Men were found to be at a higher risk than women.

In summary, there is a significant association between COVID-19 infection and the development of diabetes in the general population.

This highlights the extraordinary importance of raising awareness of the risk of diabetes in patients with COVID-19 and identifying potential factors that influence the risk.

Therefore, the management, prevention, and screening of diabetes in COVID-19 survivors should be strengthened.

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COVID-19 might be a risk factor for various chronic diseases. However, the association between COVID-19 and the risk of incident diabetes remains unclear. We aimed to meta-analyze evidence on the relative risk of incident diabetes in patients with COVID-19.


In this systematic review and meta-analysis, the Embase, PubMed, CENTRAL, and Web of Science databases were searched from December 2019 to June 8, 2022. We included cohort studies that provided data on the number, proportion, or relative risk of diabetes after confirming the COVID-19 diagnosis. Two reviewers independently screened studies for eligibility, extracted data, and assessed risk of bias. We used a random-effects meta-analysis to pool the relative risk with corresponding 95% confidence intervals. Prespecified subgroup and meta-regression analyses were conducted to explore the potential influencing factors. We converted the relative risk to the absolute risk difference to present the evidence. This study was registered in advance.


Ten articles involving 11 retrospective cohorts with a total of 47.1 million participants proved eligible. We found a 64 % greater risk of diabetes in patients with COVID-19 compared with non-COVID-19 controls, which could increase the number of diabetes events by 701 (558 more to 865 more) per 10,000 persons. We detected significant subgroup effects for type of diabetes and sex. Type 2 diabetes has a higher relative risk than type 1. Moreover, men may be at a higher risk of overall diabetes than women. Sensitivity analysis confirmed the robustness of the results. No evidence was found for publication bias.


COVID-19 is strongly associated with the risk of incident diabetes, including both type 1 and type 2 diabetes. We should be aware of the risk of developing diabetes after COVID-19 and prepare for the associated health problems, given the large and growing number of people infected with COVID-19. However, the body of evidence still needs to be strengthened.

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This is for informational purposes only. You should consult your clinical textbook for advising your patients.