# COVID-19 Infection and Diabetes Incidence in Native Americans

> **NIH NIH R34** · UNIVERSITY OF KENTUCKY · 2022 · $216,057

## Abstract

PROJECT ABSTRACT
American Indians and Alaska Natives (Native Americans) have suffered disproportionately during the COVID-
19 pandemic with higher rates of infection, hospitalization and mortality from COVID-19 compared to Non-
Hispanic Whites. Native Americans also suffer disproportionately from diabetes with nearly 3 times the
prevalence and 2.3 times the diabetes-related death rate of Non-Hispanic Whites. Growing evidence suggests
that COVID-19 infection increases the risk of developing diabetes. Large cohort studies have reported a ~50%
increased risk of developing diabetes following COVID-19 infection compared to matched or historic controls
without known COVID-19 infection. While these studies offer important insight into the magnitude of risk of new
onset diabetes following COVID-19 infection, existing studies were not inclusive of some of the highest risk
populations because they studied US veterans, commercially insured patients enrolled in large US health
insurance plans, and communities outside the US. Little is known how this risk varies across diverse
populations within the US. Understanding the epidemiologic links between COVID-19 infection and diabetes in
Native Americans is critical to address health disparities in a population that faces a disproportionate burden of
both COVID-19 and diabetes. To measure the association between COVID-19 infection and diabetes risk in
Native Americans we will conduct a series of analyses using two distinct data sources: 1) a large, nationally
representative clinical database available through Indian Health Service and 2) the Alaska Diabetes Registry
with linked electronic health record data from the Alaska Tribal Health System. Aim 1 will measure the
association between COVID-19 infection and risk of incident diabetes in Native Americans via a matched,
retrospective cohort study using national data from the Indian Health Service. Aim 2 will compare the clinical
presentation of incident diabetes cases at diabetes onset and compare clinical progression over the 6 months
following diagnosis by antecedent COVID-19 infection status in a retrospective cohort of individuals using
nationwide data from Indian Health Service as well as the comprehensive Alaska Diabetes Registry maintained
by the Alaska Native Tribal Health Consortium. The proposed studies will provide a comprehensive
epidemiologic assessment of the COVID-19-diabetes association in Native Americans, including a nationwide
description of COVID-19 infection-related diabetes risk and a deep dive into the clinical presentation of incident
diabetes cases. This knowledge will support the continued efforts of Tribal, Federal, State, and community
entities to mitigate the impacts of the COVID-19 pandemic in Native Americans and further efforts to address
the COVID-19 and diabetes health disparities faced by this population.

## Key facts

- **NIH application ID:** 10630755
- **Project number:** 3R34DK132548-01S1
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** Mary E. Lacy
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $216,057
- **Award type:** 3
- **Project period:** 2022-08-01 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10630755

## Citation

> US National Institutes of Health, RePORTER application 10630755, COVID-19 Infection and Diabetes Incidence in Native Americans (3R34DK132548-01S1). Retrieved via AI Analytics 2026-06-24 from https://api.ai-analytics.org/grant/nih/10630755. Licensed CC0.

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