CCU073: Impact of COVID-19 on the association between Type 2 diabetes and incidence of cardiovascular diseases

Project lead:
Stephen Kaptoge, University of Cambridge

Diabetes is a condition linked with abnormally high blood sugar, which can damage blood vessels and body organs. Blood sugar is regulated by a chemical called insulin. In type 1 diabetes the pancreas does not produce any insulin and mainly starts in childhood. In type 2 diabetes the pancreas does not produce enough insulin and mainly starts in adulthood.

  • People with diabetes are more likely to develop cardiovascular diseases such as heart attacks and strokes.
  • People with diabetes had worse outcomes during the COVID-19 pandemic and were more likely to die from COVID-19 or develop new health issues.
  • People who have had COVID-19 infection are more likely to get a cardiovascular disease and we know that this risk continues for up to a year after the infection.
  • We need to know more about how COVID-19 has impacted cardiovascular health in people with diabetes over the longer term.
  • We also need to know if the risk of these health problems differs by certain groups such as male and female, those from minority ethnic or poorer backgrounds, those who have more severe diabetes and those who were diagnosed with diabetes at a younger age.
  • We hope this new information will lead to new ways that help to prevent more ill health and save lives.

We aim to look deeper into the links between type 2 diabetes, age at diagnosis of diabetes and cardiovascular diseases. We will also look at whether COVID-19 infection has impacted these links. By analysing detailed population-wide linked electronic health records on 56 million people alive on 1st January 2020 in England, we will uncover new insights which have not previously been possible in studies of smaller sample size.

A deeper look into the link between type 2 diabetes and new onset cardiovascular diseases accounting for the impact of COVID-19 infection, vaccinations, age at diagnosis, severity of disease, socio-demographic characteristics (e.g. age, sex, ethnicity, deprivation, region) and clinical characteristics (e.g. history of diseases, hypertension, obesity, high cholesterol) will provide new insights to develop evidence-based strategies to improve the health of people with diabetes. Our proposed work will feed into public messaging (e.g. lifestyle changes earlier in life to reduce the risk of developing diabetes at an earlier age) that will highly likely save lives and reduce cardiovascular hospitalisation and death in people with diabetes.