The change in glycaemic control immediately after COVID-19 vaccination in people with type 1 diabetes

Heald, AH ORCID: https://orcid.org/0000-0002-9537-4050, Stedman, M, Horne, L, Rea, R ORCID: https://orcid.org/0000-0001-6515-8325, Whyte, M ORCID: https://orcid.org/0000-0002-2897-2026, Gibson, JM, Anderson, SG and Ollier, W ORCID: https://orcid.org/0000-0001-6502-6584 (2022) The change in glycaemic control immediately after COVID-19 vaccination in people with type 1 diabetes. Diabetic Medicine, 39 (4). e14774. ISSN 0742-3071

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Abstract

Aims: Evidence suggests that some people with type 1 diabetes mellitus (T1DM) experience temporary instability of blood glucose (BG) levels after COVID-19 vaccination. We aimed to assess this objectively. Methods: We examined the interstitial glucose profile of 97 consecutive adults (age ≥ 18 years) with T1DM using the FreeStyle Libre® flash glucose monitor in the periods immediately before and after their first COVID-19 vaccination. The primary outcome measure was percentage (%) interstitial glucose readings within the target range 3.9–10 mmol/L for 7 days prior to the vaccination and the 7 days after the vaccination. Data are mean ± standard error. Results: There was a significant decrease in the % interstitial glucose on target (3.9–10.0) for the 7 days following vaccination (mean 52.2% ± 2.0%) versus pre-COVID-19 vaccination (mean 55.0% ± 2.0%) (p = 0.030). 58% of individuals with T1DM showed a reduction in the 'time in target range' in the week after vaccination. 30% showed a decrease of time within the target range of over 10%, and 10% showed a decrease in time within target range of over 20%. The change in interstitial glucose proportion on target in the week following vaccination was most pronounced for people taking metformin/dapagliflozin + basal bolus insulin (change −7.6%) and for people with HbA1c below the median (change −5.7%). Conclusion: In T1DM, we have shown that initial COVID-19 vaccination can cause temporary perturbation of interstitial glucose, with this effect more pronounced in people talking oral hypoglycaemic medication plus insulin, and when HbA1c is lower.