Analysis of continuous glucose tracking data in people with Type 1
Diabetes (T1DM) after Covid-19 Vaccination reveals unexpected link
between immune and metabolic response, augmented by adjunctive oral
medication
Abstract
Introduction The COVID-19 vaccination programme is under way. Anecdotal
evidence is increasing that some people with Type 1 Diabetes Mellitus
(T1DM) experience temporary instability of blood glucose (BG) levels
post-vaccination which normally settles within 2-3 days. We report an
analysis of BG profiles of 20 individuals before and after vaccination.
Methods We examined the BG profile of 20 consecutive adults (18 years of
age or more) with T1DM using the FreeStyle® Libre flash glucose monitor
in the period immediately before and after COVID-19 vaccination. The
primary outcome measure was percentage(%) BG readings in the designated
target range 3.9-10mmmol/L as reported on the LibreView portal for 7
days prior to the vaccination (week -1) and the 7 days after the
vaccination (week +1). Results There was a significant decrease in the
%BG on target following the COVID-vaccination for the 7 days following
vaccination (mean 45.2% ±se 4.2%) vs pre-COVID-19 vaccination (mean
52.6% ±se 4.5%). This was mirrored by an increase in the proportion of
readings in other BG categories 10.1-13.9%/ ≥14%. There was no
significant change in BG variability in the 7days post COVID-19
vaccination. This change in BG proportion on target in the week
following vaccination was most pronounced for people taking
Metformin/Dapagliflozin+basal bolus insulin (-23%) vs no oral
hypoglycaemic agents (-4%), and median age <53 vs ≥53 years
(greater reduction in %BG in target for older individuals (-18% vs
-9%)). Conclusion In T1DM, we have shown that COVID-19 vaccination can
cause temporary perturbation of BG, with this effect more pronounced in
patients talking oral hypoglycaemic medication plus insulin, and in
older individuals. This may have consequences for patients with T2DM who
are currently not supported by flash glucose monitoring.