SARS-CoV-2, the virus that causes COVID-19, is linked to a higher risk of type 1 diabetes in children and adolescents, according to new research and previous studies.
The new study was conducted by Hanne Lvdal Gulseth, Dr. German Tapia, and colleagues from the Norwegian Institute of Public Health in Oslo, Norway.
The study used national health registries to compare new-onset type 1 diabetes diagnoses in Norway’s under-18 population (approximately 1.2 million people) between March 1, 2020, and March 1, 2022.
According to the lead author and Research Director at the Norwegian Institute of Public Health, Dr. Hanne Lvdal Gulseth, there may be a link between COVID-19 and newly diagnosed type 1 diabetes.
“However, the absolute risk of developing type 1 diabetes,” adds the lead author, “increased from 0.08% to 0.13%, and is still low.”
Signs and Symptoms Of New-Onset Type 1 Diabetes Develop in Kids Following Covid Infection
“The vast majority of young people who get COVID-19 will not go on to develop type 1 diabetes,” the author admits, “but it is important that clinicians and parents are aware of the signs and symptoms of type 1 diabetes.”
According to the authors, “constant thirst, frequent urination, extreme fatigue and unexpected weight loss are tell-tale symptoms.”
Type 1 diabetes, which is typically diagnosed in younger patients and is linked to the pancreas’ inability to make insulin, is thought to be the outcome of an overreactive immunological response, maybe brought on by a viral infection, such as a respiratory virus.
Risk for Newly Diagnosed Type 1 Diabetes
Several recent case reviews suggest that new cases of type 1 diabetes in adults may be linked to SARS-CoV-2 infections. However, there is less research on children.
A recent CDC report discovered that children in the US were 2.5 times more likely to get a diabetes diagnosis after contracting the SARS-CoV-2 virus, but it pooled all types of diabetes together and neglected to take other medical conditions, medications that can raise blood sugar levels, race or ethnicity, obesity, and other social determinants of health that may affect a child’s risk of contracting COVID-19 or diabetes into account.
In this nationwide study, Gulseth and his team linked information about each child and teen in Norway from national health registries (1,202,174 individuals). The data came from the Norwegian preparation registry, which is updated daily with individual-level information on PCR-confirmed SARS-CoV-2 infections, COVID-19 immunizations, and disease diagnoses from primary and secondary health care services.
Children were tracked from March 1, 2020 (the beginning of the pandemic) until the diagnosis of type 1 diabetes, their 18th birthday, death, or the end of the study (March 1, 2022).
The researchers looked at the probability of young persons having new-onset type 1 diabetes within or after 30 days of being infected with SARS-CoV2. They compared this group to children and teenagers in the general community who were not infected as well as to a group of kids who underwent testing but were confirmed to be virus-free.
Among the 1.2 million children and adolescents participating in the study, 424,354 children tested positive for SARS-CoV-2 infection over the course of the two-year trial period, and 990 new instances of type 1 diabetes were identified.
After adjusting for age, sex, country of origin, geographic area, and socioeconomic factors, the analyses found that young people who contracted COVID-19 were more likely to develop type 1 diabetes 30 days or more after infection compared to those without a registered infection or who tested negative for the virus.
“The exact reason for the increased risk of type 1 diabetes in young people after COVID-19 is not yet fully understood and requires longer-term follow-up and further research into whether the risk could be different in children who are infected with different variants,” adds Gulseth.
“It’s possible that delays in seeking care,” she adds, “because of the pandemic might explain some of the increases in new cases. However, several studies have shown that SARS-CoV-2 can attack the beta cells in the pancreas that produce insulin, which could lead to the development of type 1 diabetes. It’s also possible that inflammation caused by the virus may lead to exacerbation of already existing autoimmunity.”
The authors note that the study was observational and does not show cause and effect, and they cannot rule out the potential that other unmeasured variables (e.g., underlying conditions) or missing data may have influenced the findings.
They also remark that only children who underwent a PCR test and not lateral flow tests or asymptomatic illnesses were included in the analysis, which may restrict the validity of the conclusions.
Source: EASD 2022 Stockholm, Abstract number 233
Image Credit: Getty
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