COVID-19 May Be Triggering Type 1 Diabetes in Children

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A new study out of the UK suggests that diagnoses of Type 1 diabetes may have nearly doubled during the COVID-19 pandemic.

The study, published in the journal Diabetes Care (PDF), examined patient data from five different hospitals in the North West London region. While three of those hospitals found typical numbers of children with newly diagnosed Type 1 diabetes (T1D), the other two showed unusual increases. These two hospitals diagnosed 20 cases of T1D in April and May of this year; in a regular year they would combine for only 6.

All told, researchers found that diagnoses of Type 1 diabetes across the entire sampled region increased by 80%. The authors “postulate that SARS-CoV-2 exposure contributed to the observed increase in cases by precipitating or accelerating type 1 diabetes onset.”

In addition, the children studied had a higher than usual rate of severe diabetic ketoacidosis (DKA), suggesting that COVID-19 may amplify the speed or severity of diabetes onset.

Only a minority of the children tested positive for either COVID-19 infection or for antibodies indicating that they had already recovered from an earlier bout with the coronavirus. Such testing, however, was irregular, and it is possible that a number of children that did not get tested had also experienced infection.

It’s not exactly a smoking gun, given the small size of the sample and the patchy COVID-19 testing. Nevertheless, the study does add to the growing body of evidence attesting to a link between new onset diabetes and COVID-19.

This is a subject that ASweetLife has been monitoring for months now. In May we were among the first media sources to note the phenomenon of coronavirus-triggered “new onset diabetes,” which caused adult COVID-19 patients without any known history of diabetes to develop acute hyperglycemia and insulin resistance. At that point, the evidence was partially anecdotal, but later studies, of both patients and of laboratory experiments, added to the evidence that COVID-19 was damaging the body’s insulin-producing cells. That the same reaction could occur in children may be unsurprising.

The idea that Type 1 diabetes may in some cases be triggered by a virus has been weighed by researchers for decades. Dr. David Leslie, an expert at London’s Blizard Institute that has studied diabetes onset and prevalence, told us that viral infections are likely one of the most important non-genetic factors in the development of T1D: “I am usually very negative about viruses, because whenever a doctor doesn’t know what he’s doing, he always says it’s a virus. But the reality is that I think it probably is a virus.” If beta cell destruction can be touched off by an initial viral infection (which may occur years previous to diagnosis), environmental, genetic and lifestyle factors will then contribute to the progression in complex ways that experts can only begin to guess at.

For now, the paper’s evidence has to be considered weak, and even if the link is confirmed by further study, there are still many unanswered questions about the relationship between the novel coronavirus and new onset diabetes, in both children and adults. The Diabetes Care paper will at least help direct future research to confirm and clarify the extent of the association. Karen Logan, a co-author of the study, told Reuters that “More research is needed to establish whether there is a definitive link … but in the meantime we hope clinicians will be mindful of this.”

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