Covid-19 may increase the risk of type 1 diabetes in children

The relationship between type 1 diabetes, the less frequent, and the Covid-19 infection seems increasingly evident. According to a large study of more than 1 million children, having tested positive for SARS-CoV-2 is associated with an increased risk of new-onset type 1 diabetes in children and adolescents. The research, presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Stockholm, Sweden, used national health registries to examine new diagnoses of type 1 diabetes made in all young people under the age of 18. years in Norway (more than 1.2 million individuals) over the course of 2 years, starting on March 1, 2020, comparing those who contracted Covid-19 with those who did not. “Our nationwide study suggests a possible association between COVID-19 and new-onset type 1 diabetes,” says lead author Hanne Løvdal Gulseth, director of research at the Norwegian Institute of Public Health. “However, the absolute risk of developing type 1 diabetes increased from 0.08% to 0.13%, and remains low. The vast majority of young people who contract Covid-19 will not develop type 1 diabetes, but it is important for doctors and parents to be aware of the signs and symptoms of type 1 diabetes. Constant thirst, frequent urination, extreme fatigue and unexpected weight loss are telltale symptoms.” “The data from this observational study carried out on a Norwegian population and presented at the EASD suggest that positivity for SARS-CoV-2 confers a higher risk of developing type 1 diabetes in children and adolescents,” says Antonio Pérez, from the Hospital de la Santa Creu i Sant Pau and President of the Spanish Society of Diabetes. Inflammation caused by the virus may exacerbate existing autoimmunity. Type 1 diabetes, which is usually diagnosed in young people and is associated with the inability of the pancreas to produce insulin, has long been suspected as the result of an excessive immune reaction, possibly due to viral infection, including respiratory viruses. Some recent case reports have suggested a relationship between new-onset type 1 diabetes and SARS-CoV-2 infection in adults. But the evidence is more limited in children. A recent paper from the US Centers for Disease Control (CDC) found that US children were 2.5 times more likely to be diagnosed with diabetes after SARS-CoV-2 infection, but pooled all types of diabetes and did not take into account other health conditions, medications that can increase blood sugar levels, race/ethnicity, obesity, and other social determinants of health that might influence the risk of developing diabetes. a child acquires Covid-19 or diabetes. In this scope study, individual-level data from the national health registries of all children and adolescents in Norway (1,202,174 individuals) have been compared. Data were obtained from the Norwegian Preparedness Registry which is updated daily with individual-level data on PCR-confirmed SARS-CoV-2 infections, Covid-19 vaccinations, and primary and secondary health care service disease diagnoses. . Children were followed from March 1, 2020 (the start of the pandemic) until type 1 diabetes diagnosis, age 18, death, or end of study (March 1, 2022). , whichever came first. The researchers examined the risk of young people developing new-onset type 1 diabetes within or after 30 days of PCR-confirmed SARS-CoV2 infection. They compared this group to children and adolescents in the general population who did not have a recorded infection, as well as a group of children who were tested but were negative for the virus. Over the two years of the study, a total of 424,354 children tested positive for SARS-CoV-2 infection and 990 new cases of type 1 diabetes were diagnosed among the 1.2 million children and adolescents included in the study. After adjusting for age, gender, country of origin, geographic area, and socioeconomic factors, the analyzes found that young people who contracted Covid-19 were around 60% more likely to develop type 1 diabetes at 30 days. or more after infection, compared with those who had not reported infection or had tested negative for the virus (see figure in full abstract). “The exact reason for the increased risk of type 1 diabetes in young people after Covid-19 infection is not fully understood and requires longer-term follow-up and further research to see if the risk might be different in children. infected by different variants,” says Gulseth. Related News standard No Four cups of tea a day to control type 2 diabetes ABCSalud Drinking at least four cups of tea a day has been linked to a 17% lower risk of developing type 2 diabetes, says a controversial study And adds: «It is Delays in seeking care due to the pandemic may explain some of the increases in new cases. However, several studies have shown that SARS-CoV-2 can attack the beta cells of the pancreas that produce insulin, which could lead to the development of type 1 diabetes. It is also possible that the inflammation caused by the virus causes an exacerbation of pre-existing autoimmunity’. The authors acknowledge that the study was observational and does not demonstrate cause and effect, and cannot rule out the possibility that other unmeasured factors (eg, underlying conditions) or missing data may have affected the results. We still do not know the exact reason for the increased risk of developing type 1 diabetes in young people after contracting Covid-19 Antonio Pérez President SED Due to the characteristics of the study, adds the president of the SED, “a cause-effect relationship cannot be established. effect and therefore we still do not know the exact reason for the increased risk of developing type 1 diabetes in young people after contracting Covid-19 and the possible effect of factors related to the deterioration of health care during the pandemic and others. variables not considered. However, the relationships acquire « robustness when dealing with findings that confirm those observed in previous studies carried out both in children and adults in other populations, and the existence of studies that have shown that SARS-CoV-2 can directly affect cells beta from the pancreas and indirectly exacerbating autoimmunity. Pending studies that allow a better definition of the association between Covid-19 and an increased risk of diabetes, Pérez points out that these data contribute to “insist on the importance of preventing Covid-19 in children and adolescents and be alert to the detection of the possible appearance of diabetes three suffering infection by SARS-CoV-2 ».