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. 2023 Nov 2;45(2):281–308. doi: 10.1210/endrev/bnad032

Table 1.

Studies that compared the risk of diabetes in adults with COVID-19 vs adults with other respiratory illness

Author Populations Follow-up Outcome Risk
Al-Aly et al, 2021 (42) COVID-19 (n = 13 654)
Influenza (13 997)		 COVID-19: 150 (84-217) da
Influenza: 157 (87-220) da 		DM—complication
DM + complication
T1D
T2D
DM, otherc 		HR (95% CI)
1.09 (.95-1.25)
1.11 (.96-1.28)
.70 (.49-1.01)
1.14 (.96-1.34)
.83 (.65-1.07)
Al-Aly et al, 2022 (52) Breakthrough SARS-CoV-2 infection (n = 3667)
Seasonal influenza (n = 14 337)		 6 mo DM
Insulin use		 HR (95% CI)
1.40 (1.05-1.87)
1.60 (1.26-2.05)
Birabaharan et al, 2022 (53) COVID-19a:

  • Mild (n = 313 924)

  • Moderate/severe (n = 10 436)

Influenzad:

  • Mild (n = 319 783)

  • Moderate/severe (n = 10 951)

 6 mo T2D RR (95% CI)
1.54 (1.46-1.62) [mild]
1.22 (1.14-1.29) [mild, no steroidsa,d]
1.46 (1.26-1.69) [moderate/severe]
1.42 (1.13-1.80) [moderate/severe, no steroidsa,d)
Cohen et al, 2022 (54) COVID-19 (n = 73,490, ≥ 65 y)
VLRTI (n = 73,490, ≥ 65 y)		 68 (23-155) da T2D HR (95% CI)
1.23 (1.02-1.48)
Daugherty et al, 2021 (55) COVID-19 (n = 181,613, 18-65 y)
VLRTI (n = 181,613, 18-65 y)		 87 (45-124) da T2D HR (95% CI)
1.39 (1.22-1.58)
Holman et al, 2023 (56) COVID-19, no pneumonia (n = 58 091)
COVID-19 pneumonia (n = 29 006)
non-COVID-19 pneumonia, year:

  • 2020 (n = 99 951),

  • 2019 (n = 117 148),

  • 2018 (n = 110 489)

  • 2017 (n = 102 733)

 ≥2 wk after hospital discharge DM IR (95% CI)
16.4 (12.8-20.7) [COVID-19 no pneumonia, reference]
19.0 (13.8-25.6) [COVID-19 pneumonia]
Non-COVID pneumonia:

  • 16.6 (13.3-20.4) [2020]

  • 13.7 (10.8-17.3) [2019]

  • 13.8 (10.9-17.4) [2018]

  • 14.2 (10.9-18.3) [2017]
Lu et al, 2023 (21) COVID-19 (n = 4982)
Influenza (n = 2988)		 COVID-19: 83 db
Influenza: 87 daysb 		T2D OR (95% CI)
1.24 (1.07-1.45)
OpenSafely Collaborative, 2022 (57) COVID-19 (n = 77 347) vs non-COVID-19 pneumonia (n = 127 987) 0–≥120 d T2D SHR (95% CI)
1.30 (1.15-1.47)
Rathmann et al, 2022 (58) COVID-19 (n = 35 865)
AURI (n = 35 865)		 COVID-19: 119 (0-210) da
AURI: 161 (4-225) da 		T2D
DM, otherc 		IRR (95% CI)
1.28 (1.05-1.57)
1.17 (.80-1.71)

Abbreviations: AURI, acute upper respiratory tract infections; DM, diabetes mellitus; HR, hazard ratio; IR, incidence rate per 1000 person-years; IQR, interquartile range; IRR, incidence rate ratio; OR, odds ratio; RR, relative risk; SHR, subdistribution hazard ratios; VLRTI, viral lower respiratory tract illness.

Follow-up data are adays, median (IQR) or bdays, mean.

c Because of underlying condition, drug or chemical induced, or other specified type; a276 748 (88%) of those with mild COVID-19 and 5357 (51%) of those with moderate/severe COVID-19 were not treated with steroids

d 280 851 (88%) and 5424 (50%) of those with moderate/severe influenza were not treated with steroids

* No significant difference between COVID-19 without pneumonia and other groups.