Scientists are still learning about the impact of COVID-19 more than three years after the start of the pandemic. The latest finding from a new study: Children who had COVID have a higher risk of developing type 1 diabetes.
The study, which was published in JAMA, analyzed data from nearly 1.2 million children in Bavaria. Of those, 1,242 children received a diagnosis of type 1 diabetes through December 2019. Among children who didn't have a type 1 diabetes diagnosis at the start of 2020, 195,795 were diagnosed with COVID between January 2020 and December 2021.
The study found that, in children diagnosed with COVID, rates of type 1 diabetes diagnoses jumped significantly. There were nearly 29 type 1 diabetes cases per 100,000 person-years in children who didn't have a COVID-19 diagnosis, compared to more than 55 type 1 diabetes cases per 100,000 person-years during the same quarter as a child who was diagnosed with COVID. (Person-years is a measure that takes the total number of study participants and multiplies that by the years patients were in the study.)
The researchers concluded that COVID contributed to the “increase in type 1 diabetes incidence during the pandemic.”
This isn't the first study to link COVID with an increased risk of a type 1 diabetes diagnosis in kids. A study published in JAMA last year found that children who had COVID carried a 72% higher risk of being diagnosed with type 1 diabetes than those with no history of the virus.
But the link between COVID and a diabetes diagnosis is not only found in children. A JAMA study published in February found that adults who had a known COVID infection were at a 58% higher risk of being diagnosed with any type of diabetes than those who hadn't had the virus. Another JAMA study published in April found that people infected with COVID were significantly more likely to be diagnosed with type 2 diabetes within a year of having the virus, compared to those without a COVID diagnosis. Men were also more likely to be diagnosed with women and people who were hospitalized with the virus were more than twice as likely to be diagnosed with diabetes.
While researchers are hesitant to say that COVID causes diabetes, there's a growing body of evidence to suggest that it might. "This study found that SARS-CoV-2 infection was associated with a higher risk of diabetes, suggesting that these infections may have contributed to an excess burden of diabetes at the population level," researchers concluded in the most recent study.
Doctors say they're seeing this uptick in diabetes cases in practice too. “Usually you see maybe one new type 1 diabetes case every 10 years — I’ve seen four cases in the last year,” Daniel Ganjian, a pediatrician at Providence Saint John’s Health Center in Santa Monica, Calif., tells Yahoo Life. “There is definitely an increase in the amount of diabetes cases we are seeing.”
But what’s going on here and what does it mean for kids? Experts explain.
Why might COVID lead to a type 1 diabetes diagnosis in kids?
For the record, many doctors don’t think this link is a coincidence. “While these studies don’t absolutely, unequivocally establish cause and effect, there’s a biological plausibility that this is real,” Thomas Russo, a specialist in infectious disease at the University of Buffalo, tells Yahoo Life.
The exact reason why there’s a link — and whether COVID-19 actually causes diabetes — is still being investigated. However, there are some theories about what could be behind this.
The leading theory is that the virus causes some people to develop so-called autoantibodies — that is, antibodies directed at their own bodies. “Autoantibodies can develop and be directed toward pancreatic cells that produce insulin, leading to diabetes,” Russo explains. (Type 1 diabetes occurs when the pancreas doesn't make any insulin, while with type 2 diabetes the pancreas doesn't make enough insulin, causing blood sugar to spike, according to the National Institute of Diabetes and Digestive and Kidney Diseases.)
It's also possible that COVID-19 directly damages cells in the pancreas, causing issues with insulin production, Russo says.
But COVID causes inflammation in the body as a whole, Ganjian points out. “That likely causes inflammation in the pancreas as well, and may make it malfunction,” he says.
Why is this so significant?
Diabetes is a serious and typically lifelong disease that requires careful management, Ganjian says. “Type 1 diabetes doesn’t resolve. Children will have it forever,” he says. A diagnosis like this can be life-altering for a child, Russo says.
“We’re learning that there are consequences of getting a COVID infection beyond acute disease, hospitalization and bad outcomes,” Russo says.
The link between COVID-19 and diabetes also raises questions about other viruses and the disease. “It’s important for us to research to see if other viruses are associated with diabetes and, if so, what we can do to mitigate the effects of them,” Ganjian says.
What do parents need to know?
Russo stresses the importance of vaccinating kids against COVID. “Even though their risk of severe disease and bad outcomes is low compared to other populations, it may help,” he says. “Earlier studies show this association was primarily in unvaccinated children. Vaccination isn’t perfect, but it does seem to help protect against severe disease and potential consequences.”
Given how common COVID is, Ganjian urges parents to be on the lookout for diabetes symptoms in kids. "If you're seeing a child that has vague issues — they’re drinking more, peeing more and are tired — think about diabetes,” he says. It's important for parents and clinicians to have this on their radar.”
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