Research led by Helmholtz Munich in Germany showed COVID-19 infection in high-risk young people almost doubled the rate of progression to type 1 diabetes during the pandemic compared with those who were not infected with the virus.
The pandemic showed that COVID-19 increased the risk of diabetes. A systemic review published in 2022 showed risk of developing type 1 diabetes was 48% higher and type 2 diabetes 70% higher after SARS-CoV-2 infection compared with non-infected individuals.
However, the link between SARS-CoV-2 infection and progression to type 1 diabetes in people already at high risk for the disease, defined as positive results for two or more autoantibodies linked to the condition, was less clear.
Writing in JAMA, Anette-Gabriele Ziegler, MD, a professor at Helmholtz Munich, and colleagues report results of a study of 509 children aged one to sixteen years who were at high risk of developing type 1 diabetes.
The children in the study were followed up to assess rates of type 1 diabetes development both before and after the pandemic period between 2015 and 2023. For the purposes of the study, the start of the pandemic was designated as 1 March 2020.
Overall, 57 of the participants developed type 1 diabetes before the pandemic and 113 during the pandemic period. This translated to a pre-pandemic incidence rate of type 1 diabetes of 6.4 per 100 person years vs 12.1 in the pandemic period.
In children with a known SARS-CoV-2 infection during the pandemic, the incidence rate of type 1 diabetes was 14 per 100 person years versus 8.6 per 100 person years in those who tested negative for infection.
The researchers note that there was no information available on COVID-19 severity in this group, which could have impacted the results.
“The findings are consistent with previously reported acceleration of progression in children with presymptomatic type 1 diabetes by viral infection,” write the authors.
“Further studies are required to determine whether COVID-19 also accelerates progression to type 1 diabetes in adults and whether vaccination and monitoring for COVID-19 symptoms should be considered for individuals with presymptomatic type 1 diabetes.”
