Evidence map›Paper›PMID 39054034›Full record

ArticleThe lancet. Diabetes & endocrinology2024

Incidence of diabetes after SARS-CoV-2 infection in England and the implications of COVID-19 vaccination: a retrospective cohort study of 16 million people.

Kurt Taylor, Sophie Eastwood, Venexia Walker, Genevieve Cezard, Rochelle Knight, Marwa Al Arab, Yinghui Wei, Elsie M F Horne, Lucy Teece, Harriet Forbes and 20 more

Abstract read
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In one paragraph

Article in The lancet. Diabetes & endocrinology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  15. Long COVID: current research and future directions.Infectious diseases & immunity · 2025
    Review
  16. Endocrinology: What You May Have Missed in 2024.Annals of internal medicine · 2025
    Review
  17. Article
  18. Observational
  19. Observational
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

30 authors.

Kurt TaylorPopulation Health Sciences, University of Bristol, Bristol, UK.
Sophie EastwoodMRC Unit for Lifelong Health and Ageing, University College London, London, UK.
Venexia WalkerPopulation Health Sciences, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Genevieve CezardBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.
Rochelle KnightPopulation Health Sciences, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; NIHR Bristol Biomedical Research Centre, Bristol, UK; The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston, Bristol, UK.
Marwa Al ArabPopulation Health Sciences, University of Bristol, Bristol, UK.
Yinghui WeiCentre for Mathematical Sciences, School of Engineering, Computing and Mathematics, University of Plymouth, Plymouth, UK.
Elsie M F HornePopulation Health Sciences, University of Bristol, Bristol, UK; NIHR Bristol Biomedical Research Centre, Bristol, UK.
Lucy TeeceDepartment of Population Health Sciences, University of Leicester, Leicester, UK.
Harriet ForbesFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Alex WalkerThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Louis FisherThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Jon MasseyThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Lisa E M HopcroftThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Tom PalmerPopulation Health Sciences, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
Jose Cuitun CoronadoPopulation Health Sciences, University of Bristol, Bristol, UK.
Samantha IpBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK; Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Simon DavyThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Iain DillinghamThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Caroline MortonThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Felix GreavesNational Institute for Health and Care Excellence, Manchester, UK; Department of Primary Care and Public Health, Imperial College London, London, UK.
John MacleodPopulation Health Sciences, University of Bristol, Bristol, UK; NIHR Bristol Biomedical Research Centre, Bristol, UK; The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston, Bristol, UK.
Ben GoldacreThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Angela WoodBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK; British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK; National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK; Cambridge Centre of Artificial Intelligence in Medicine, University of Cambridge, Cambridge, UK; Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK.
Nishi ChaturvediMRC Unit for Lifelong Health and Ageing, University College London, London, UK.
Jonathan A C SternePopulation Health Sciences, University of Bristol, Bristol, UK; NIHR Bristol Biomedical Research Centre, Bristol, UK; Health Data Research UK South-West, Bristol, UK. Electronic address: jonathan.sterne@bristol.ac.uk.
Rachel DenholmPopulation Health Sciences, University of Bristol, Bristol, UK; NIHR Bristol Biomedical Research Centre, Bristol, UK; Health Data Research UK South-West, Bristol, UK.
Longitudinal Health and Wellbeing and Data and Connectivity UK COVID-19 National Core Studies
CONVALESCENCE study
OpenSAFELY collaborative

Funding

British Heart Foundation RE/18/1/34212British Heart Foundation RG/13/13/30194British Heart Foundation RG/18/13/33946Medical Research Council MC_PC_20059Wellcome Trust
6 · The paper itself

Abstract

backgroundSome studies have shown that the incidence of type 2 diabetes increases after a diagnosis of COVID-19, although the evidence is not conclusive. However, the effects of the COVID-19 vaccine on this association, or the effect on other diabetes subtypes, are not clear. We aimed to investigate the association between COVID-19 and incidence of type 2, type 1, gestational and non-specific diabetes, and the effect of COVID- 19 vaccination, up to 52 weeks after diagnosis.

methodsIn this retrospective cohort study, we investigated the diagnoses of incident diabetes following COVID-19 diagnosis in England in a pre-vaccination, vaccinated, and unvaccinated cohort using linked electronic health records. People alive and aged between 18 years and 110 years, registered with a general practitioner for at least 6 months before baseline, and with available data for sex, region, and area deprivation were included. Those with a previous COVID-19 diagnosis were excluded. We estimated adjusted hazard ratios (aHRs) comparing diabetes incidence after COVID-19 diagnosis with diabetes incidence before or in the absence of COVID-19 up to 102 weeks after diagnosis. Results were stratified by COVID-19 severity (categorised as hospitalised or non-hospitalised) and diabetes type.

findings16 669 943 people were included in the pre-vaccination cohort (Jan 1, 2020-Dec 14, 2021), 12 279 669 in the vaccinated cohort, and 3 076 953 in the unvaccinated cohort (both June 1-Dec 14, 2021). In the pre-vaccination cohort, aHRs for the incidence of type 2 diabetes after COVID-19 (compared with before or in the absence of diagnosis) declined from 4·30 (95% CI 4·06-4·55) in weeks 1-4 to 1·24 (1·14-1.35) in weeks 53-102. aHRs were higher in unvaccinated people (8·76 [7·49-10·25]) than in vaccinated people (1·66 [1·50-1·84]) in weeks 1-4 and in patients hospitalised with COVID-19 (pre-vaccination cohort 28·3 [26·2-30·5]) in weeks 1-4 declining to 2·04 [1·72-2·42] in weeks 53-102) than in those who were not hospitalised (1·95 [1·78-2·13] in weeks 1-4 declining to 1·11 [1·01-1·22] in weeks 53-102). Type 2 diabetes persisted for 4 months after COVID-19 in around 60% of those diagnosed. Patterns were similar for type 1 diabetes, although excess incidence did not persist beyond 1 year after a COVID-19 diagnosis.

interpretationElevated incidence of type 2 diabetes after COVID-19 is greater, and persists for longer, in people who were hospitalised with COVID-19 than in those who were not, and is markedly less apparent in people who have been vaccinated against COVID-19. Testing for type 2 diabetes after severe COVID-19 and the promotion of vaccination are important tools in addressing this public health problem.

fundingUK National Institute for Health and Care Research, UK Research and Innovation (UKRI) Medical Research Council, UKRI Engineering and Physical Sciences Research Council, Health Data Research UK, Diabetes UK, British Heart Foundation, and the Stroke Association.

Indexed as

COVID-19COVID-19 VaccinesSARS-CoV-2AdolescentAdultAgedAged, 80 and overCohort StudiesDiabetes MellitusDiabetes Mellitus, Type 2EnglandFemaleHumansIncidenceMaleMiddle AgedCOVID-19 Vaccines

Identifiers

PMID39054034
PMCPMC7617111

What Socratic holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.