Analysis of continuous glucose tracking data in people with type 1 diabetes after COVID-19 vaccination reveals unexpected link between immune and metabolic response, augmented by adjunctive oral medication.
Journal
International journal of clinical practice
ISSN: 1742-1241
Titre abrégé: Int J Clin Pract
Pays: India
ID NLM: 9712381
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
31
05
2021
accepted:
17
07
2021
pubmed:
11
8
2021
medline:
1
1
2022
entrez:
10
8
2021
Statut:
ppublish
Résumé
The COVID-19 vaccination programme is under way worldwide. Anecdotal evidence is increasing that some people with type 1 diabetes mellitus (T1DM) experience temporary instability of blood glucose (BG) levels post-vaccination which normally settles within 2-3 days. We report an analysis of BG profiles of 20 individuals before/after vaccination. We examined the BG profile of 20 consecutive adults (18 years of age or more) with T1DM using the FreeStyle Libre flash glucose monitor in the period immediately before and after COVID-19 vaccination. The primary outcome measure was percentage (%) BG readings in the designated target range 3.9-10 mmmol/L as reported on the LibreView portal for 7 days prior to the vaccination (week -1) and the 7 days after the vaccination (week +1). There was a significant decrease in the %BG on target following the COVID-vaccination for the 7 days following vaccination (mean 45.2% ± SE 4.2%) vs pre-COVID-19 vaccination (mean 52.6% ± SE 4.5%). This was mirrored by an increase in the proportion of readings in other BG categories 10.1%-13.9%/≥14%. There was no significant change in BG variability in the 7days post-COVID-19 vaccination. This change in BG proportion on target in the week following vaccination was most pronounced for people taking Metformin/Dapagliflozin+basal-bolus insulin (-23%) vs no oral hypoglycaemic agents (-4%), and median age <53 vs ≥53 years (greater reduction in %BG in target for older individuals (-18% vs -9%)). In T1DM, we have shown that COVID-19 vaccination can cause temporary perturbation of BG, with this effect more pronounced in patients talking oral hypoglycaemic medication plus insulin, and in older individuals. This may also have consequences for patients with T2DM who are currently not supported by flash glucose monitoring.
Identifiants
pubmed: 34375490
doi: 10.1111/ijcp.14714
pmc: PMC8420568
doi:
Substances chimiques
Blood Glucose
0
COVID-19 Vaccines
0
Hypoglycemic Agents
0
Insulin
0
Glucose
IY9XDZ35W2
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14714Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Eur J Gen Pract. 2020 Dec;26(1):129-133
pubmed: 32985278
Immunity. 2018 Jul 17;49(1):164-177.e6
pubmed: 29958802
Ann Fam Med. 2020 Jul;18(4):349-354
pubmed: 32661037
Diabetes Metab Syndr. 2021 Mar-Apr;15(2):505-508
pubmed: 33662837
Diabetes Spectr. 2018 May;31(2):206-208
pubmed: 29773944
Diabetes Care. 2020 Jul;43(7):1378-1381
pubmed: 32409505
Br J Hosp Med (Lond). 2018 Nov 2;79(11):634-639
pubmed: 30418830
Front Endocrinol (Lausanne). 2019 Oct 30;10:703
pubmed: 31736870
N Engl J Med. 2020 Dec 31;383(27):2603-2615
pubmed: 33301246
Cardiovasc Endocrinol Metab. 2020 Jun 16;9(4):171-176
pubmed: 33225233
J Pak Med Assoc. 2015 Dec;65(12):1360-2
pubmed: 26627526
Lancet. 2021 Jan 9;397(10269):99-111
pubmed: 33306989
N Engl J Med. 2005 Dec 22;353(25):2643-53
pubmed: 16371630
BMJ. 2021 Feb 2;372:n308
pubmed: 33531333
Int J Clin Pract. 2021 Dec;75(12):e14714
pubmed: 34375490
Diabetes. 2003 Jul;52(7):1761-9
pubmed: 12829644
BMJ. 2011 Jul 07;343:d3805
pubmed: 21737469