Doctors in the UK say there may be a link between COVID-19 and new-onset type 1 diabetes (T1D) in children after observing a spike in new T1D cases during the pandemic this year.
The study, which included data from five London hospitals during the peak of the coronavirus pandemic (23 March to 4 June), revealed a surge in new cases of T1D. Thirty children, aged 23 months to 16 years presented with new-onset T1D, 70% of whom also experienced diabetic ketoacidosis (DKA). In comparison with a typical year, the doctors estimate this represents an additional 12–15 new T1D cases (80% increase).
Dr Karen Logan from the Imperial College Healthcare NHS Trust told the BBC T1D has genetic risk, but environmental factors can also contribute to developing the disease. She said the study found “a high number of new cases, compared to previous years”.
“When we investigated further, some of these children had active COVID-19 or had evidence of having previously been exposed to the virus.”
The angiotensin converting enzyme 2 (ACE2) receptor is the binding site for SARS-CoV-1 and -2 and is strongly expressed in pancreatic endocrine cells. Previous evidence suggests that SARS-CoV-1 virus may have entered pancreatic islet cells via the ACE2 receptor leading to b-cell damage and new-onset, mainly transient diabetes.
This has led the team of doctors to believe that COVID-19 could be “triggering some of these children to develop T1D, particularly if they are already susceptible to developing T1D.”
“While our data does not prove a link, we hypothesize that SARS-CoV-2 exposure contributed to the observed increase in cases by precipitating or accelerating onset of T1D in these children.”
Further studies are required to establish a definitive link and any possible impact on the severity of type 1 diabetes presentation.