Study finds link between COVID-19 infections and type 1 diabetes

People who have been diagnosed with COVID-19 may be at higher risk of developing the autoimmune disease Type 1 diabetesaccording to a study of more than 27 million people across the United States.

Researchers found that patients infected with SARS-CoV-2, the coronavirus that causes COVID-19, were 42% more likely to develop type 1 diabetes than those who had not contracted COVID-19 for the study period.

The risk is highest in the youngest pediatric patients (those younger than 1 year had a 584% increased risk) and high in older adult patients with COVID-19. The researchers also observed differences between races and ethnicities, with the risk of type 1 diabetes associated with COVID-19 infection being most pronounced among American Indians/Alaska Natives (increased risk of 130 %), Asian/Pacific Islander (101%) and Black. sick (59%).

Trenton Honda, clinical professor and associate dean at Northeastern University’s Bouvé College of Health Sciences

“Particularly in pediatric populations, [COVID-19] is generally not a life-threatening condition, often not serious. But type 1 diabetes is usually a lifelong disease that requires considerable contact with the medical community, increases your risk of death, increases your risk of long-term comorbidity,” says Trenton-HondaClinical Professor and Associate Dean at Northeastern’s Bouvé College of Health Sciencesand a member of the research team led by Fares Qeadan at Loyola University Chicago.

“Our interest is really to look at the question, ‘Will there be hidden costs, even among those who are not at high risk for COVID itself, because of COVID, later on?'” Said Honda.

Scientists also investigated whether patients who had type 1 diabetes before contracting COVID-19 were more likely to suffer from a serious and life-threatening complication called diabetic ketoacidosis after being infected with the virus. They found that patients with type 1 diabetes and subsequently infected had a 126% increased risk of developing diabetic ketoacidosis compared to those who had not been infected. Their results were published in the PLOS One review earlier this month.

Honda uses the word “association” to refer to the increased risk, be careful not to say that a COVID-19 infection causes Onset of type 1 diabetes.

“We are the first US population study in a very, very large national data set to be able to say that people with COVID appear to be at a higher risk of developing type 1 diabetes, although we are not in able to say that COVID cause this increased risk. It could be any number of things,” he says. To establish this causal link, Honda says, researchers would need to do a randomized controlled trial. Instead, the team looked at anonymized data from more than 27 million people who came into contact with hospital medical care across the United States from December 2019 to the end of July 2021.

There is other evidence that links COVID-19 infection with an increased risk of being diagnosed with type 1 diabetes. SARS-CoV-2 is not the first virus to be associated with an increased risk of onset of type 1 diabetes. It has also been linked to several viral infections such as mumps, rubella, cytomegalovirus and Epstien-Barr virus.

Photo by Eduardo Parra/Europa Press via Getty Images

It all comes down to the pancreas.

Every cell in your body depends on sugar (glucose) for fuel, Honda explains. But some cells need a hormone called insulin to absorb glucose from the blood. Insulin is produced by the pancreas in response to changes in blood sugar.

Type 2 diabetes is usually a problem with insulin resistance that develops in the cells that need it. But type 1 diabetes is an autoimmune disease, Honda says. “Essentially, your body produces antibodies and immune cells that come in and destroy cells that produce insulin. So you end up with this extremely low insulin level over time. And what that means is that the cells in our body that need insulin to get sugar stop using sugar and start using fat. And in doing so, they alter the entire metabolism of the body and set up an acidotic state which is ultimately fatal.

Before what Honda calls “one of the greatest moments in all of medical history” when insulin was purified from pigs, type 1 diabetes was a death sentence. Now it’s a lifelong disease that can be survived with blood sugar monitoring and insulin injections.

With other viruses, scientists believe the way the virus invades pancreatic cells causes them to die spontaneously, Honda says. And when they die, the immune system is mobilized to destroy these dead cells. The idea, he says, is that it could promote the development of an autoimmune response to these cells – and it could spiral out of control and continue to attack these vital insulin-producing cells in the pancreas.

“This is how other viruses are presumed to lead to type 1 diabetes,” Honda says. “So that’s the logic behind this study.”

This study focused on COVID-19 cases in the absence of vaccines. Honda says the next big question is whether vaccination against SARS-CoV-2 is linked to an additional or minimized risk of type 1 diabetes.

The research team also aims to study associations between 40 other autoimmune diseases and COVID-19 infections.

“If we only think about the burden of disease caused by COVID, it is entirely possible that the immediate disease will have a much, much smaller impact, especially on people at low risk of the disease itself. “, says Honda. “And we could end up with a lot of lifelong disorders that develop…from exposure to COVID.”

For media inquiriesplease contact Marirose Sartoretto at [email protected] or 617-373-5718.

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