Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jun 15, 2023; 14(6): 892-918
Published online Jun 15, 2023. doi: 10.4239/wjd.v14.i6.892
Correlation between COVID-19 vaccination and diabetes mellitus: A systematic review
Yan-Fei He, Jing Ouyang, Xiao-Dong Hu, Ni Wu, Zhi-Gang Jiang, Ning Bian, Jie Wang
Yan-Fei He, Ni Wu, Ning Bian, Jie Wang, Health Management Center, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
Jing Ouyang, Casualty Management Section, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
Xiao-Dong Hu, Department of Endocrinology, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
Zhi-Gang Jiang, Department of Statistics, Zunyi Medical University, Zunyi 563006, Guizhou Province, China
Author contributions: He YF designed the study, reviewed literature, and drafted the manuscript; Ouyang J, Hu XD and Wu N retrieved and summarized the literature; Jiang ZG, Bian N and Wang J advised on the review and reviewed the final manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Fei He, MD, Associate Chief Physician, Doctor, Health Management Center, The Sixth Medical Center, Chinese PLA General Hospital, No. 6 Fu Cheng Road, Haidian District, Beijing 100048, China. heyanfeilc@163.com
Received: December 23, 2022
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

We searched all current clinical studies to explore the complex relationship between COVID-19 vaccination and diabetes.

Research objectives

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.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

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.