{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T17:07:25Z","timestamp":1773248845591,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T00:00:00Z","timestamp":1762041600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["MedComm"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Diabetes is associated with an increased risk of coronavirus disease 2019 (COVID\u201019)\u2010associated morbidity and mortality. COVID\u201019 vaccines substantially reduce the risk of serious COVID\u201019 outcomes, making them important for individuals with diabetes. However, the effects of the COVID\u201019 vaccines on glucose control in patients with diabetes remain unclear. Here, we demonstrate that COVID\u201019 vaccine boosters impair insulin sensitivity in both mice and patients with type 2 diabetes (T2D). In mice, the administration of four vaccine doses elevated the levels of SARS\u2010CoV\u20102 spike protein and impaired glucose tolerance and insulin sensitivity. Mechanistically, we showed that the SARS\u2010CoV\u20102 spike protein, guided by the mRNA COVID\u201019 vaccine, interferes with insulin signaling by binding to angiotensin\u2010converting enzyme 2, TLR4, and ER. We found that 66% of T2D patients exhibited aggravated insulin resistance to booster shots of the mRNA COVID\u201019 vaccine. Furthermore, treatment with metformin improved insulin signaling variations induced by COVID\u201019 vaccine boosters in mice. These findings indicate that COVID\u201019 vaccine boosters impair insulin sensitivity in T2D and that metformin may mitigate these effects. These results maintain the risk\u2013benefit ratio in favor of COVID\u201019 vaccination for the prevention of severe clinical outcomes, yet highlight the need for close glycemic monitoring of patients with diabetes after receiving mRNA COVID\u201019.<\/jats:p>","DOI":"10.1002\/mco2.70469","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T05:36:49Z","timestamp":1762148209000},"source":"Crossref","is-referenced-by-count":1,"title":["SARS\u2010CoV\u20102 Spike Protein as a Target of the COVID\u201019 Vaccine Disrupts Insulin Signaling in Type 2 Diabetes"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3907-5910","authenticated-orcid":false,"given":"Lixiang","family":"Zhai","sequence":"first","affiliation":[{"name":"Centre For Chinese Herbal Medicine Drug Development Hong Kong Baptist University  Hong Kong SAR China"},{"name":"School of Chinese Medicine Hong Kong Baptist University  Hong Kong SAR 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