A new paper shows that type 1 diabetes (T1D) is strongly linked to a common genus of viruses.
The Australian study found that people with T1D were eight times more likely to get an enterovirus (Genus of viruses) infection than people without T1D.
The incidence of type 1 diabetes (T1D), the most common form of diabetes in children, has been steadily rising over the past several decades around the world. People with this condition have an immune system that attacks and kills the beta cells in the pancreas that make insulin. This keeps the body from making enough of the hormone to control blood sugar levels properly.
High blood sugar levels can shorten life expectancy and harm the kidneys, foot, eyes, heart, and eyes over time. Additionally, diabetic ketoacidosis, a disease that frequently occurs at the time of T1D diagnosis and involves the accumulation of dangerous compounds known as ketones in the blood, can be fatal if not treated promptly.
Although the specific cause of the immune system’s response is still up for debate, it is generally accepted that a genetic predisposition and one or more environmental triggers, like virus infection, work together.
There is mounting evidence that enteroviruses are to blame for this crisis. Hand, foot, and mouth disease (HFMD), polio, and other viruses that cause milder, cold-like symptoms are all members of this large group.
Sonia Isaacs, of the Department of Paediatrics and Child Health, School of Clinical Medicine, University of New South Wales, Australia, and associates conducted a systematic review and meta-analysis of prior studies on the subject to further examine the correlation.
Data from 12,077 people (age 0-87 years) from 60 controlled observational studies retrieved from the PubMed and Embase databases were used to conduct the meta-analysis, making it the largest of its kind.
5,981 of the people who took part had either T1D or islet autoimmunity (which typically progresses to T1D). 6,096 people had neither disease.
RNA or protein from the enterovirus, which is a sign of a current or recent infection, was found in blood, stool, and tissue samples using a variety of advanced molecular techniques.
People with islet autoimmunity were twice as likely as those without it to test positive for enteroviruses.
People with T1D had an eight-fold higher risk of contracting an enterovirus infection than people without the condition.
Most importantly, people with T1D were 16 times more likely than people without T1D to have an enterovirus infection in the month after they were diagnosed with T1D.
According to the study’s findings, there is a direct link between enterovirus infection and both islet autoimmunity and type 1 diabetes (T1D).
“These findings provide further support for ongoing work to develop vaccines to prevent the development of islet autoimmunity and therefore reduce the incidence of T1D.” Ms. Isaacs says.
There are a number of hypotheses as to why enteroviruses raise the possibility of T1D. Their interaction with genes may be key.
According to Ms. Isaacs’ study, those with T1D who also have a first-degree relative with the disease are 29 times more likely to get an enterovirus infection.
“The number, timing and duration and even the site of enterovirus infections may also be important. The ‘leaky gut’ hypothesis suggests that viruses originating in the gut could travel along with activated immune cells to the pancreas, where a low-level, persistent infection and resulting inflammation can lead to an autoimmune response.
“Virus infections are also proposed to work in combination with other factors such as diet, imbalances in the gut microbiome and even chemical exposures which may occur in utero (during pregnancy) or early childhood. There is still a lot to learn.”
Source: EASD 2022 Stockholm, Abstract number 236
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