Impact of COVID-19 Vaccination on Glycemia in Individuals With Type 1 and Type 2 Diabetes: Substudy of the COVAC-DM Study

Abstract

Vaccination and potentially related side effects might impact glucose management in people with diabetes. In this study, we investigated effects of COVID-19 vaccination on glycemia assessed by continuous glucose monitoring (CGM) in people with type 1 and type 2 diabetes. <br> 74 participants of the ongoing multicenter prospective COVAC-DM-study, investigating the immune response to COVID-19 vaccines in people with diabetes, were willing to participate in this CGM sub-study. Time spent in glycemic ranges (time in range [TIR] 70-180 mg/dL; time below range [TBR] <70 mg/dL and time above range [TAR] >180 mg/dL) was assessed daily from two days prior to three days after the first COVID-19 vaccination. Participants were asked to document side effects in response to vaccination, insulin injections, and carbohydrate intake.<br> 58 participants with type 1 (27 female, mean age 39.5 years, HbA1c 57 ± 12 mmol/mol) and 16 with type 2 diabetes (9 females, mean age 60.6 years, HbA1c 63 ± 11mmol/mol) were included in this study. The mean TIR did not change on the day of the vaccination and the following 3 days (p>0.05). In people with type 1 diabetes, the TIR (p=0.033) and the TAR (p= 0.043) deteriorated on days with side effects as compared to those without. <br> Side effects occurring after COVID-19 vaccination significantly reduce the TIR and increase the TAR in people with type 1 diabetes, while no impact was observed in people with type 2 diabetes.

Comparison between D‐dimer levels in diabetic and non‐diabetic positive COVID‐19 adult patients: A hospital‐based study

“…It is well recognized that the extent and severity of the infection are related to diabetic status. Some of the potential mechanisms explaining this situation are altered immune response, cytokine storm and glucose metabolism 4 …”

“…Some of the potential mechanisms explaining this situation are altered immune response, cytokine storm and glucose metabolism. 4 Diabetes patients have a greater risk of getting various infections.…”

COVID-19 Vaccine-Induced Rapid Progression of Prediabetes to Ketosis-Prone Diabetes Mellitus in an Elderly Male

“…But, this rapid progression, especially within a year of detection of low prediabetic HbA1c to severely high HbA1c with ketoacidosis at presentation preceded by a recent COVID-19 vaccine administration, shows a temporal association and probable cause of this endocrine exacerbation. Dysglycemia in Type 1 or 2 DM is increasingly reported after COVID-19 infection or vaccination but rarely reported about the rapid progression of prediabetes to Type 1 diabetes mellitus [ 4 ]. Postulated mechanisms are cytokine-mediated pancreatic beta-cell damage or autoimmunity after mRNA vaccines or as a part of autoimmune syndrome induced by vaccine adjuvants (ASIA syndrome) [ 5 - 7 ].…”

Third dose of COVID‐19 vaccine in diabetes: Relevance of good metabolic control to improve its efficacy

“…More recently, no significant differences in glucose control were also observed in patients with autoimmune diabetes, expressed as time in range evaluated by CGM comparing the 3 days after SARS‐Cov‐2 vaccine with the 14 days preceding the vaccine 10 . Nonetheless, deterioration in glycaemia was still observed in people with T1D when side effects were reported following the administration of COVID‐19 vaccine 11 …”