Publication type
Journal Article
Series Number
Authors
Publication date
September 19, 2025
Summary:
Objective:
To examine whether pre-pandemic diabetes is associated with an increased risk of Long COVID in a nationally representative UK cohort.
Methods:
We conducted a prospective cohort analysis using data from the UK Household Longitudinal Study. A total of 11,669 adults aged ≥ 16 years were followed from Wave 10 (2018–19) to Wave 14 (2022–23). The primary exposure, pre-pandemic diabetes, was defined at baseline (Wave 10) based on self-report of a doctor diagnosis. The primary outcome, Long COVID, was assessed at follow-up (Wave 14) and defined as self-reported symptoms lasting more than 12 weeks after a COVID-19 infection that could not be explained by another cause. Modified Poisson regression models with robust standard errors were used to estimate relative risks of Long COVID associated with pre-pandemic diabetes. Predictive margins were then calculated to obtain adjusted probabilities.
Results:
At follow-up, 1,076 participants (9.2%) reported Long COVID. In the unadjusted model, participants with pre-pandemic diabetes had a 36% higher risk of Long COVID compared with those without diabetes (RR = 1.36, 95% CI: 1.09–1.69, p = 0.006). After adjusting for age and sex, the relative risk increased to 1.43 (95% CI: 1.15–1.79, p = 0.002). In the fully adjusted model, which controlled for age, sex, ethnicity, education, income satisfaction, smoking, and other long-standing illness, the relative risk of Long COVID in participants with diabetes was 1.60 (95% CI: 1.27–2.02, p < 0.001). The adjusted predicted probability of long COVID was 14.4% (95% CI: 11.2–17.6) among those with diabetes, compared with 9.0% (95% CI: 8.5–9.5) among those without.
Conclusions:
In this nationally representative prospective cohort, pre-pandemic diabetes emerged as an independent risk factor for Long COVID. Enhanced surveillance and targeted support for individuals with diabetes may be warranted in Long COVID care strategies.
Published in
Journal of Diabetes & Metabolic Disorders
Volume
Volume: 24:207
DOI
https://doi.org/10.1007/s40200-025-01731-4
ISSN
22516581
Subjects
Notes
Open Access
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Uses Understanding Society data (not Understanding Society - COVID-19 Study, 2020)
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