T2D Diagnoses Spike Coincident With COVID Onset

Researchers published the study covered in this summary on medRxiv as a preprint that has not yet been peer reviewed.

Key Takeaways

  • A sharp spike in new diagnoses of type 2 diabetes occurred starting 7 days before and continuing for 30 days after onset of infection with COVID-19 (SARS-CoV-2), followed by a decrease in new diagnoses of diabetes out to a year later, in a study of data from a large US database collected during the first 2 years of the pandemic.

  • Inherent limitations of the cross-sectional data this study used means that the results do not imply a causal relationship. The main conclusion from this analysis is that the relationship between COVID-19, pandemic-related lifestyle changes, and diabetes is complex and requires careful study using appropriate control cohorts.

Why This Matters

  • A growing body of evidence suggests a possible increased incidence of new-onset type 2 diabetes after a SARS-Cov-2 infection because of multiple potential causes.

  • Assessment of the causal relationships between SARS-CoV-2 infection and development of diabetes in both the short term and long term requires rigorous epidemiologic and mechanistic studies.

  • People were less physically active and rates of overweight and obesity, as well as stress, increased during the pandemic. Thus, the risk of developing diabetes has potentially increased regardless of infection with SARS-CoV-2.

Study Design

  • The researchers analyzed electronic health records from patients who were seen at more than 70 US institutions participating in the National Covid Cohort Collaborative (N3C) database and had both incident SARS-CoV-2 infection and incident type 2 diabetes during the period March 2020-February 2022, at least one outpatient visit at least 6 months prior to their SARS-CoV-2 infection, and at least 6 months of follow-up data.

Key Results

  • During each month from March 2020-June 2022, roughly 20,000 to more than 400,000 patients with new-onset SARS-Cov-2 infection also received a diagnosis of incident type 2 diabetes.

  • The data showed a sharp increase in type 2 diabetes diagnoses from 7 days prior to 30 days after patients received their COVID-19 diagnosis, followed by a decrease in new diagnoses during the post-acute period out to 360 days after the infection.

  • The percentage of newly diagnosed cases of type 2 diabetes decreased by about 2%-3% each month after the initial COVID-19 diagnosis.


  • This was an observational study that cannot address cause and effect.

  • In some patients, the type 2 diabetes may have been related to the stress of a SARS-CoV-2 infection. But in other patients, diabetes may have been detected as a result of increased interaction of the patient with healthcare providers and increased A1c testing because of their COVID-19 diagnosis.


  • The study received no direct commercial support.

  • Three of the 12 co-authors had commercial disclosures detailed in the preprint.

This is a summary of a preprint research preprint research study, “Are fewer cases of diabetes mellitus diagnosed in the months after SARS-CoV-2 infection?” written by a multicenter team of US researchers on medRxiv, provided to you by Medscape. This study has not yet been peer reviewed. The full text of the study can be found on medrxiv.org.

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