Nikhil Prasad Fact checked by:Thailand Medical News Team Sep 17, 2026 37 minutes ago
A large study suggests COVID-19 may leave people with type 2 diabetes facing elevated risks of vitamin and mineral deficiencies for years after infection, alongside higher rates of osteoporosis and fractures.
Researchers I-Wen Chen, Li-Chen Chang, and Kuo-Chuan Hung analyzed electronic health records from the predominantly U.S.-based TriNetX Global Collaborative Network. The researchers are from the Department of Anesthesiology at Chi Mei Hospital in Liouying, Tainan City; the Department of Anesthesiology at E-Da Hospital, I-Shou University in Kaohsiung City; and the Department of Anesthesiology at Chi Mei Medical Center in Tainan City, Taiwan.
COVID-19 was associated with higher long-term risks of vitamin D, magnesium, and vitamin B12 deficiencies in
adults with type 2 diabetes.
More than 1.29 million matched patients
The retrospective study identified adults with type 2 diabetes during 2020–2022. After a 12-month landmark period and propensity-score matching, 645,168 people with COVID-19 were compared with 645,168 controls without recorded COVID-19. Patients with pre-existing micronutrient deficiencies or specified skeletal outcomes were excluded, helping researchers focus on newly developing problems.
Over an up-to-five-year analytic window, COVID-19 was associated with a 79% higher hazard of vitamin D deficiency, 77% higher hazard of magnesium deficiency, and 56% higher hazard of vitamin B12 deficiency. The COVID-19 group also had higher hazards of osteoporosis, osteoporotic fracture, and femur fracture—55%, 73%, and 58% higher, respectively.
Testing-specific analysis strengthens the signal
Because deficiencies can only be identified when patients are tested, the investigators separately analyzed people who received the relevant laboratory tests. Vitamin D deficiency occurred in 19.1% of tested COVID-19 patients versus 12.8% of controls, an absolute difference of 6.4 percentage points. Magnesium deficiency affected 25.1% versus 20.0%, while vitamin B12 deficiency occurred in 4.4% versus 3.4%.
This
Thailand Medical News report also highlights a severity pattern: severe COVID-19 was associated with particularly elevated hazards of osteoporotic fracture, femur fracture, and magnesium deficiency. Competing-risk analyses likewise showed higher cumulative incidence of all three nutrient deficiencies after COVID-19 despite higher mortality.
Why COVID-19 could affect nutrition
The researchers proposed several possible explanations, including persistent inflammation, reduced food intake, gastrointestinal problems, altered gut microbiota, reduced sunlight exposure and mobility, and renal or metabolic disturbances. These pathways may be especially relevant in people with type 2 diabetes because of existing metabolic and renal vulnerability.
However, the study was observational and cannot prove COVID-19 caused the deficiencies. Testing differences, incomplete records, unme
asured diet and supplement use, medication exposure, lifestyle factors, and other residual confounding could have influenced the results.
Conclusion
The findings suggest that delayed micronutrient abnormalities may be an underrecognized part of post-COVID health in people with type 2 diabetes, with potentially important implications for bone health. Prospective studies using standardized laboratory testing are needed to establish causality and determine whether targeted screening or correction of deficiencies improves meaningful clinical outcomes.
The study findings were published in the peer reviewed journal: Frontiers in Nutrition.
https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2026.1915257/full
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