Disseminated herpes zoster hospitalization linked to higher newly identified diabetes, prediabetes prevalence

This retrospective cohort analysis examined 564 patients hospitalized for herpes zoster (HZ) to determine the prevalence of newly identified diabetes and prediabetes. The study compared patients with disseminated HZ (n=45) to those with localized HZ (n=519). The primary outcome was prevalence of newly identified diabetes and prediabetes.

Patients with disseminated HZ had a significantly higher prevalence of newly identified diabetes (22.2% or 10/45) compared to those with localized HZ (11.9% or 62/519), with a P-value of 0.048. The prevalence of prediabetes was also significantly higher in the disseminated group (33.3% or 15/45) versus the localized group (13.1% or 68/519), with a P-value <0.001. Independent risk factors for diabetes identified included disseminated HZ, age >60 years, BMI >25 kg/m², elevated LDL-C, and elevated triglycerides.

Safety and tolerability data were not reported in this analysis. The key limitation is the retrospective observational design, which can only demonstrate association, not causation. The study population was limited to hospitalized HZ patients, and generalizability to outpatient or community settings is uncertain.

For clinical practice, this evidence suggests an association between disseminated HZ presentation and higher rates of undiagnosed dysglycemia in hospitalized patients. However, given the observational nature of the data, this should not be interpreted as causal. The findings support considering glycemic screening in hospitalized HZ patients, particularly those with disseminated disease, while recognizing this represents routine clinical assessment rather than a novel therapeutic approach.