Covid-19 Is Linked With Increased Risk Of Type 1 Diabetes In Children And Adolescents: Study

A total of 4,24,354 children tested positive for Covid-19, over the study period. Among the 1.2 million children in Norway, 990 individuals were diagnosed with new-onset cases of type 1 diabetes.

Researchers from the Norwegian Institute of Public Health, Oslo, Norway, used national health registers to examine new-onset type 1 diabetes diagnoses made in all youngsters aged below 18 years in Norway, over the course of two years, starting March 1, 2020. (Representative Image)

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Covid-19 is linked with an increased risk of new-onset type 1 diabetes in children and adolescents, a new study reports. The research was presented at this year's European Association for the Study of Diabetes (EASD) Annual Meeting held in Stockholm, Sweden, from September 19 to 23. As part of the study, researchers from the Norwegian Institute of Public Health, Oslo, Norway, used national health registers to examine new-onset type 1 diabetes diagnoses made in all youngsters aged below 18 years in Norway, over the course of two years, starting March 1, 2020.

There are over 1.2 million youngsters in Norway. The researchers compared the youngsters who contracted Covid-19 and those who did not. The abstract for the study was presented at the European Association for the Study of Diabetes Annual Meeting. 

In a statement released by Diabetologia, the official journal of the European Association for the Study of Diabetes, Dr Hanne Løvdal Gulseth, the lead author on the paper, says the nationwide study suggests a possible association between Covid-19 and new-onset type 1 diabetes. She also says that the absolute risk of developing type 1 diabetes increased from 0.08 to 0.13 per cent, and is still low. 

Gulseth notes that the vast majority of young people who get Covid-19 will not go on to develop type 1 diabetes but it is important that clinicians and parents are aware of the signs and symptoms of type 1 diabetes, which include constant thirst, frequent urination, extreme fatigue and unexpected weight loss.

Type 1 Diabetes Is Associated With Failure Of Pancreas To Produce Insulin

Type 1 diabetes has long been suspected to be the result of an over-responsive immune reaction. This reaction may happen due to a viral infection, including that caused by respiratory viruses. Type 1 diabetes is usually diagnosed in younger people, and is associated with the failure of the pancreas to produce insulin. 

According to recent case reports, there could be a link between new-onset type 1 diabetes and SARS-CoV-2 infection in adults. However, the evidence is more limited in children. 

Children in the United States were 2.5 times more likely to be diagnosed with diabetes following a SARS-CoV-2 infection, a recent report by the Centers for Disease Control and Prevention found. The limitations to the study are that it pooled all types of diabetes together and did not account for other health conditions, race, ethnicity, medications that can increase blood sugar levels, social determinants of health, and obesity, according to the statement. All these factors could influence a child's risk of contracting Covid-19 or acquiring diabetes.

How The Study Was Conducted

As part of the new nationwide study, Gulseth and her colleagues linked individual-level data from national health registries for all children and adolescents in Norway. They obtained the data from the Norwegian preparedness register that is updated daily with individual-level data on PCR-confirmed SARS-CoV-2 infections, Covid-19 vaccinations, and disease diagnoses from the primary and secondary healthcare service. 

The researchers followed children from March 1, 2020, which marked the beginning of the Covid-19 pandemic, until the diagnosis of type 1 diabetes, until they turned 18 years of age or until the end of the study, on March 1, 2022. 

Gulseth and her colleagues examined the risk of young people developing new-onset type 1 diabetes within or after 30 days after PCR-confirmed SARS-CoV-2 infection, and compared this group with children and adolescents in the general population who did not have a registered infection, as well as to a group of children who were tested but found to be negative for SARS-CoV-2. 

How Many Norwegian Children Tested Positive For Covid-19 During The Study Period?

A total of 4,24,354 children tested positive for Covid-19, over the two-year study period. Among the 1.2 million children in Norway, 990 individuals were diagnosed with new-onset cases of type 1 diabetes.

Important Findings Of The Study

The researchers adjusted their data for age, sex, country of origin, geographical area and socio-economic factors, and found that young people who contracted Covid-19 were around 60 per cent 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 SARS-CoV-2.

Gulseth said 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 infected with different variants.

She explained that delays in seeking care because of the Covid-19 pandemic might have resulted in an increase in new-onset type 1 diabetes. 

Gulseth added that 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. Inflammation caused by SARS-CoV-2 may lead to exacerbation of already existing autoimmunity. 

The authors highlighted some limitations to the study, including the possibility of unmeasured factors such as underlying conditions affecting the results.