Published online Jun 15, 2023. doi: 10.4239/wjd.v14.i6.892
Peer-review started: December 23, 2022
First decision: March 28, 2023
Revised: April 5, 2023
Accepted: April 24, 2023
Article in press: April 24, 2023
Published online: June 15, 2023
Processing time: 174 Days and 2.7 Hours
Both coronavirus disease 2019 (COVID-19) and diabetes pose a serious threat to human health. Vaccination is an effective way to prevent the spread of COVID-19. There are few and conflicting data on the interaction between COVID-19 vaccination and diabetes mellitus.
We searched all current clinical studies to explore the complex relationship between COVID-19 vaccination and diabetes.
We analyzed various factors and possible mechanisms of the interaction between COVID-19 vaccination and diabetes in order to inform the optimal vaccination strategy and clinical management of patients with diabetes.
We comprehensively searched PubMed, MEDLINE, and EMBASE online databases and the grey literature of medRxiv and bioRxiv using keywords individually or in combination, with a cut-off date of December 2, 2022. We followed the inclusion and exclusion criteria and studies with quantifiable evidence were included in the full-text review. We also manually searched for important references cited by the included studies.
A total of 54 studies were included. The earliest study began in November 2020. Thirty studies discussed the effect of diabetes on COVID-19 vaccination, with the majority indicating that diabetes decreases the response to vaccination. Of the other 24 studies on the effect of vaccination on diabetes, most concluded that vaccination was associated with a risk of elevated blood glucose. Twelve of the 54 studies expressed a "no effect" relationship between diabetes and vaccination.
There is a bidirectional relationship between vaccination and diabetes. Vaccination may contribute to the risk of elevated blood glucose in diabetic patients, and diabetes may have a lower antibody response after vaccination than in the general population, but good glycemic control can significantly improve the immune response.
Our review reveals a complex relationship between diabetes and vaccination and suggests some gaps in the literature that can be addressed in the future, necessitating well-designed large-scale studies to further provide a more comprehensive basis for the relationship between diabetes and COVID-19.