tetano
Editor, Senior Moderator
Diabetes Metab Res Rev
. 2026 Feb;42(2):e70136.
doi: 10.1002/dmrr.70136.
Long-Term Risk of Incident Type 2 Diabetes Following SARS-CoV-2 Infection: A Population-Based Study in British Columbia, Canada
Héctor Alexander Velásquez García[SUP] 1 2 [/SUP], Stanley Wong[SUP] 1 2 [/SUP], Dahn Jeong[SUP] 1 2 3 [/SUP], Zaeema Naveed[SUP] 2 3 [/SUP], Bushra Mahmood[SUP] 2 4 [/SUP], Geoffrey McKee[SUP] 1 2 3 [/SUP], Naveed Zafar Janjua[SUP] 1 2 3 5 [/SUP]
Affiliations
Aims: To assess the long-term risk of incident type 2 diabetes mellitus (T2DM) following SARS-CoV-2 infection in a large population-based cohort.
Materials and methods: We conducted a retrospective cohort study of all British Columbia residents aged ≥ 18 years tested for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR) between 1 January 2020 and 31 January 2024. Individuals with pre-existing diabetes or residing in long-term care were excluded. Incident T2DM, identified more than 30 days after testing, was ascertained using a validated administrative algorithm. Inverse probability-weighted cause-specific hazard models estimated adjusted hazard ratios (HRs) for incident diabetes, accounting for death as a competing risk. Subgroup analyses examined associations by sex, age, vaccination status, COVID-19 severity, and follow-up duration.
Results: Among 2,044,421 individuals (296,390 SARS-CoV-2-positive; 1,748,031 negative), 47,704 (2.33%) incident T2DM cases were identified over a median follow-up of 874 days. Compared with the SARS-CoV-2-negative group, the risk of diabetes was higher among infected individuals (HR 1.18; 95% CI: 1.15-1.22; p < 0.0001), rising progressively with illness severity-from ambulatory to hospitalised and intensive-care cases. No evidence of association was found among the vaccinated subgroups. The excess risk persisted for up to 3 years before waning thereafter.
Conclusions: SARS-CoV-2 infection was associated with an increased risk of incident T2DM that persisted for up to 3 years, particularly among unvaccinated and severely ill individuals. These findings highlight the importance of post-infection metabolic surveillance and the potential protective role of vaccination.
Keywords: COVID‐19; SARS‐CoV‐2; administrative data; population‐based longitudinal cohort; survival analysis; type 2 diabetes mellitus.
. 2026 Feb;42(2):e70136.
doi: 10.1002/dmrr.70136.
Long-Term Risk of Incident Type 2 Diabetes Following SARS-CoV-2 Infection: A Population-Based Study in British Columbia, Canada
Héctor Alexander Velásquez García[SUP] 1 2 [/SUP], Stanley Wong[SUP] 1 2 [/SUP], Dahn Jeong[SUP] 1 2 3 [/SUP], Zaeema Naveed[SUP] 2 3 [/SUP], Bushra Mahmood[SUP] 2 4 [/SUP], Geoffrey McKee[SUP] 1 2 3 [/SUP], Naveed Zafar Janjua[SUP] 1 2 3 5 [/SUP]
Affiliations
- PMID: 41689767
- PMCID: PMC12906328
- DOI: 10.1002/dmrr.70136
Aims: To assess the long-term risk of incident type 2 diabetes mellitus (T2DM) following SARS-CoV-2 infection in a large population-based cohort.
Materials and methods: We conducted a retrospective cohort study of all British Columbia residents aged ≥ 18 years tested for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR) between 1 January 2020 and 31 January 2024. Individuals with pre-existing diabetes or residing in long-term care were excluded. Incident T2DM, identified more than 30 days after testing, was ascertained using a validated administrative algorithm. Inverse probability-weighted cause-specific hazard models estimated adjusted hazard ratios (HRs) for incident diabetes, accounting for death as a competing risk. Subgroup analyses examined associations by sex, age, vaccination status, COVID-19 severity, and follow-up duration.
Results: Among 2,044,421 individuals (296,390 SARS-CoV-2-positive; 1,748,031 negative), 47,704 (2.33%) incident T2DM cases were identified over a median follow-up of 874 days. Compared with the SARS-CoV-2-negative group, the risk of diabetes was higher among infected individuals (HR 1.18; 95% CI: 1.15-1.22; p < 0.0001), rising progressively with illness severity-from ambulatory to hospitalised and intensive-care cases. No evidence of association was found among the vaccinated subgroups. The excess risk persisted for up to 3 years before waning thereafter.
Conclusions: SARS-CoV-2 infection was associated with an increased risk of incident T2DM that persisted for up to 3 years, particularly among unvaccinated and severely ill individuals. These findings highlight the importance of post-infection metabolic surveillance and the potential protective role of vaccination.
Keywords: COVID‐19; SARS‐CoV‐2; administrative data; population‐based longitudinal cohort; survival analysis; type 2 diabetes mellitus.