Variations in the Risk of New‐Onset Diabetes Following <scp>COVID</scp> ‐19 Infection Across Body Mass Index, Deprivation, Ethnicity and Geographic Regions: Population‐Based Cohort Study in 42 Million People in England

AIMS: Evidence suggests that COVID-19 may be associated with an increased risk of diabetes. We aimed to examine this association by investigating the role of socioeconomic and metabolic factors on the risk of new-onset type 2 (T2D) and type 1 (T1D) diabetes after COVID-19 diagnosis. MATERIALS AND METHODS: We conducted a retrospective, population-based cohort study using linked electronic health records from NHS England's Secure Data Environment for England via the CVD-COVID-UK/COVID-IMPACT consortium. Adults (≥ 18 years), alive, registered with a general practice within 1 January 2020 and 28 May 2024 were included. Exposed individuals with confirmed COVID-19 diagnosis and no prior diabetes were matched to up to three unexposed individuals without COVID-19 and diabetes on age, sex, region and deprivation. Flexible parametric survival models were used to estimate associations between COVID-19 and incident diabetes by sex and across age, BMI, deprivation, ethnicity, and region. RESULTS: in unexposed 70-year-old men. Similarly, higher deprivation and Asian ethnicity were also more strongly associated with the risk of T2D than COVID-19 exposure. There was no evidence of an association between COVID-19 and T1D across all analyses. CONCLUSIONS: In this cohort, COVID-19 was associated with a modest, short-term increase in T2D risk and showed no meaningful association with T1D. Established metabolic, demographic and socioeconomic factors-including age, BMI, deprivation and ethnicity-were more strongly associated with T2D incidence than COVID-19 exposure.