Adults with Type 1 diabetes may have transient increases in glucose levels in the days after receiving a Covid-19 vaccine booster, according to a study published in Diabetes Research and Clinical Practice.
“For the majority of people with Type 1 diabetes, the Covid-19 booster does not cause clinically significant effects on glucose levels or control.” Says Andrew P. Demidowich, MD, assistant professor of medicine in the division of endocrinology, diabetes and metabolism at Johns Hopkins University School of Medicine, told Healio. “However, in rare cases, people with Type 1 diabetes may experience transient glycemic elevations on the day of vaccination and lasting up to five days. Therefore, patients and providers should be made aware of this possibility.”
Demidowich and colleagues conducted a study of 21 adults with Type 1 diabetes who previously received a primary Covid-19 vaccine. Participants were given a masked Dexcom G6 continuous glucose monitor at an initial visit three to four days before receiving a Covid-19 vaccine booster. A follow-up visit in which the CGM was removed took place 10 days after the initial visit, or five to six days after receiving the booster.
Of the participants, 13 received a Pfizer-BioNTech booster and eight received a Moderna booster. Mean daily glucose increased from 162.9 mg/dL to 172.8 mg/dL two days after vaccination and to 173.1 mg/dL three days after vaccination. Four participants had at least a 25% increase in glucose on the day of vaccination and one day after vaccination compared with baseline. Three participants had at least a 25% elevation in glucose compared with baseline on days two and five.
“Vaccinations are designed to stimulate the immune system, leading to an inflammatory response,” said researcher Mihail Zilbermint, MD, MBA, FACE, associate professor of clinical medicine at Johns Hopkins University School of Medicine and chief and director of endocrinology, diabetes and metabolism at Suburban Hospital in Bethesda. “Inflammation can have a significant impact on glucose regulation. It may lead to insulin resistance, where the body’s cells become less responsive to insulin, resulting in higher blood glucose levels.”
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