2023-05-22 15:27:40
During the COVID-19 pandemic, there was a sharp increase in type 1 diabetes in children, also in Germany. It is not yet clear why the incidence of the chronic autoimmune disease increased during the pandemic. Researchers from Helmholtz Munich and TU Dresden, in cooperation with the Bavarian Association of Statutory Health Insurance Physicians (KVB), are now investigating whether there is a connection between infection with the SARS-Cov-2 virus and the development of type 1 diabetes. To do this, they evaluated data from 1.1 million children with statutory health insurance who were born in Bavaria between 2010 and 2018.
Although studies had already found an increase in the incidence of type 1 diabetes during the COVID-19 pandemic, no distinction was made between children with and without SARS-CoV-2 infection. The research team has now gained new insights: the KVB data set provides information on whether children suffering from type 1 diabetes have previously had COVID-19. This allows conclusions to be drawn about a temporal connection between COVID-19 disease and the occurrence of type 1 diabetes. Among the children included in the study who were not yet diagnosed with type 1 diabetes at the start of the pandemic, 16.6 percent had been diagnosed with COVID-19 between January 2020 and December 2021.
SARS-CoV-2 infection associated with increased risk of type 1 diabetes in children
The researchers’ results initially agree with other observations from Germany and other countries: the incidence of type 1 diabetes in children between the ages of 2 and 12 increased by 50 percent in the period 2020 to 2021 compared to the period 2018 to 2019. In addition, the data shows that type 1 diabetes was more common among children diagnosed with COVID-19 in 2020-2021. After undergoing SARS-CoV-2 infection, the children had a 57 percent increased risk of developing type 1 diabetes compared to children without an infection. The type 1 diabetes incidence increased mainly in the same quarter in which the children had a SARS-CoV-2 infection, but also in the quarters that followed.
Results indicate a direct link between SARS-CoV-2 infection and type 1 diabetes
“We are cautious about interpreting our results, but the virus could either promote the development of the autoimmunity underlying type 1 diabetes, or enhance an already existing autoimmunity and thus accelerate the destruction of insulin-producing beta cells,” says Ezio Bonifacio, Last author of the study. Further studies are therefore necessary to elucidate the exact mechanism behind the increased occurrence of type 1 diabetes in children in connection with a SARS-CoV-2 infection.
Further studies are already being planned
With the Global Platform for the Prevention of Autoimmune Diabetes (GPPAD) and the Fr1da study, the team behind the study has access to prospective cohorts of children followed over several years. “We would like to look at these cohorts to see whether islet autoantibodies and/or a type 1 diabetes diagnosis occur more frequently after infection with SARS-CoV-2,” says Anette-Gabriele Ziegler, Director of the Helmholtz Munich Institute for Diabetes Research and head of the Research platform GPPAD. The results of other studies should also answer the question of whether a SARS-CoV-2 vaccination could preventively reduce the risk of type 1 diabetes in young children.
Originalpublikation
Weiss et al. (2023): Type 1 Diabetes Incidence and Risk in Children With a Diagnosis of COVID-19. JAMA. doi:10.1001/jama.2023.8674
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