{
  "abstract": "Objective: We aimed to quantify the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the risk of incident diabetes. We also aimed to estimate the global burden of incident type 2 diabetes (T2D) attributable to SARS-CoV-2 infection.\n\nMethods: We conducted a systematic review and meta-analysis of cohort studies identified through PubMed, Embase, Web of Science and CENTRAL from inception to 29 January 2026. Adjusted relative risks (RRs) for incident T2D and type 1 diabetes (T1D) following SARS-CoV-2 infection were pooled using random-effects models. Population attributable fractions (PAFs) and attributable T2D cases were estimated by integrating pooled risk estimates with Global Burden of Disease (GBD) 2023 data on COVID-19 prevalence and T2D incidence.\n\nResults: Fifteen cohort studies involving approximately 48.9 million participants were included. SARS-CoV-2 infection was associated with an increased risk of incident T2D (13 studies; pooled RR, 1.25 [95% CI, 1.16–1.34]), although substantial heterogeneity was observed and the 95% prediction interval (PI) included the null (0.94–1.66). In subgroup analysis, the association was confined to mixed-variant studies (RR, 1.29 [95% CI, 1.23–1.36]; 95% PI, 1.09–1.54), whereas studies evaluating a single variant (Delta or Omicron) showed no excess risk (RR, 1.00 [95% CI, 0.97–1.03]). The association with incident T1D did not reach conventional statistical significance (10 studies; pooled RR, 1.13 [95% CI, 0.99–1.30]). Globally, 24.53 million incident T2D cases occurred in 2023. The PAF attributable to COVID-19 of 1.12% (95% CI 0.90, 1.35), corresponding to 274,889 (95% CI 220,360, 331,698) incident T2D cases attributable to SARS-CoV-2 infection. The largest attributable burdens were observed in India, the USA, and China.\n\nConclusions: SARS-CoV-2 infection was associated with a modest increase in pooled T2D risk. This association was primarily observed in mixed-variant studies, for which the 95% PI excluded the null. However, the overall pooled estimated was accompanied by substantial between-study heterogeneity, and its 95% PI crossing the null, indicating uncertainty in the association across populations and settings. At the population level, this excess risk translated into an estimated 275,000 incident T2D cases attributable to COVID-19 worldwide in 2023, highlighting the need for ongoing metabolic surveillance following infection.\n\nSystematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261307969 , identifier CRD420261307969.",
  "abstract_shown": true,
  "affiliations": [
    "Institute of Evidence-Based Medicine, Heping Hospital Affiliated to Changzhi Medical College",
    "Department of Clinical Laboratory, Heping Hospital Affiliated to Changzhi Medical College",
    "Department of Public Health and Preventive Medicine, Changzhi Medical College",
    "Department of Medical Statistics, School of Public Health, Zhejiang Chinese Medical University",
    "School of Public Health, Southern Medical University"
  ],
  "article_type": "systematic review",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jingjing Li"
    },
    {
      "affs": [
        1
      ],
      "name": "Guangming Liu"
    },
    {
      "affs": [
        2
      ],
      "name": "Jianzhou Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Haimiao Ma"
    },
    {
      "affs": [
        3
      ],
      "name": "Xiaoyan Wang"
    },
    {
      "affs": [
        3
      ],
      "name": "Ziying Jiang"
    },
    {
      "affs": [
        4
      ],
      "name": "Yuanhao Liang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Xiaofeng He"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/as3jwfc497wvy.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1969341",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13719592/?tool=EBI",
  "id": "as3jwfc497wvy",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1969341/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Systematic Review"
    ],
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      "openalex",
      "2725|COVID-19 Clinical Research Studies"
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  "pdf_url": "https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1969341/pdf",
  "pmcid": "PMC13719592",
  "pmid": "42964334",
  "published": "2026-10-16",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/as3jwfc497wvy.ris",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|COVID-19 Clinical Research Studies",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Global burden of type 2 diabetes attributable to SARS-CoV-2 infection",
  "title_text": "Global burden of type 2 diabetes attributable to SARS-CoV-2 infection",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:20:37Z",
  "url": "https://research.draconitic.com/paper/as3jwfc497wvy",
  "venue": "Frontiers in Immunology",
  "versions": []
}