Glycemic Adverse Effects of Sars-CoV-2 Vaccination

Abstract

Nasser Mikhail and Soma wali

Background: Several cases of diabetes were recently reported in individuals vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Objective: To determine characteristics and patterns of glycemic changes occurring after SARS-CoBV-2 vaccination. Methods: Pubmed search up to May 9, 2022. Search terms are diabetes, hyperglycemia, SARS-Cov-2, vaccine, COVID-19, hyperglycemic crisis. Case reports, case series, pertinent in-vitro studies and review articles are included. Results: In ambulatory patients with type 1 diabetes, COVID-19 vaccination may transiently worsen glycemic control as measured by continuous glucose monitoring (CGM). 5 cases of newly diagnosed immune-mediated type 1 diabetes were reported 7-28 days after administration of COVID-19 vaccines. 4 Japanese patients presented with fulminant type 1 diabetes 3-6 days after receiving COVID-19 vaccines. 10 patients with newly diagnosed type 2 diabetes presented with hyperglycemic crises 3-36 days post-vaccination. In 7 patients with pre-existing type 1 and type 2 diabetes, COVID-19 vaccine has triggered hyperglycemic crises 15 hours to 10 days post-vaccination. These glycemic adverse effects may occur following the first or second dose of various types of COVID-19 vaccines. The underlying mechanisms are unclear but are likely multifactorial. No specific subject or vaccine factors that might predispose to develop glycemic complications of COVID-19 vaccine could be identified.
Conclusions: The timing of onset of glycemic complications in relation to COVID-19 vaccine administration suggests a causal relationship. Physicians and vaccinated individuals with and without diabetes should be mindful of these uncommon glycemic adverse effects of COVID-19 vaccine.

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