medwireNews: Findings from the COVAC-DM study suggest that people with type 1 or type 2 diabetes have an antibody response to COVID-19 vaccination that is similar to healthy individuals, with no association between glycemic control and antibody levels.
The study included 75 people with type 1 diabetes and 75 people with type 2 diabetes who received two doses of a vaccine against SARS-CoV-2, most commonly the Pfizer–BioNTech (BNT162b2) vaccine (86.0%). The antibody responses in these individuals were compared with those of 86 healthy controls recruited in a partner study, most (96.5%) of whom were given the Moderna (mRNA-1273) vaccine.
Harald Sourij (Medical University of Graz, Austria) and team report that at 14–21 days after the second vaccine dose, median levels of antibodies against the SARS-CoV-2 spike protein in the type 1 diabetes, type 2 diabetes, and control groups were approximately 600, 400, and 500 units/mL, respectively. There were no significant between-group differences after adjustment for age, sex, and correction for multiple comparisons.
When the diabetes groups were categorized based on glycemic control, there were no significant differences in anti-spike antibody levels among those with type 1 diabetes and glycated hemoglobin (HbA1c) levels of up to (n=49) or above (n=26) 7.5% (58 mmol/mol) and those with type 2 diabetes and HbA1c levels of up to (n=37) or above (n=38) this threshold in the adjusted analysis.
Moreover, in an adjusted quantile regression analysis, HbA1c category was not a significant predictor of antibody levels across all diabetes groups, and use of insulin treatment was not significantly associated with the antibody response among people with type 2 diabetes.
These findings are in contrast to those from the CAVEAT study, reported previously by medwireNews, which demonstrated an association between poor glycemic control and impaired antibody response to COVID-19 vaccination, write Sourij et al in Diabetes, Obesity and Metabolism.
The researchers carried out correlation analyses in the pooled diabetes population, finding that age was “a major determinant of humoral immune response to a COVID-19 vaccination,” with a correlation coefficient (r) of –0.45. Estimated glomerular filtration rate was also significantly associated with antibody levels (r=0.28), and there was a weak inverse correlation between BMI and the humoral response (r=–0.18).
They caution that the study had a number of limitations, including lack of information on the T-cell response to vaccination and the fact that most people in the diabetes and healthy control groups received different vaccines.
The authors conclude: “Additional information on cellular immune response [and] further follow up in our and other clinical trials will help to clarify the full picture of vaccination effects and trajectories of antibody levels after COVID-19 vaccination in people with diabetes.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group
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