We have a lot of data that shows that the rate of type 1 diabetes has increased since the COVID-19 pandemic. However, it’s not clear whether or not this increase is due in part (or entirely) to COVID-19. Studies of COVID and type 1 diabetes have found mixed results, so we need more information to fully answer this question.
What is type 1 diabetes?
There are multiple types of diabetes including type 1, type 2, and gestational diabetes. This post is focused on type 1.
Type 1 diabetes is an autoimmune disease where the immune system attacks beta cells in the pancreas. These cells are responsible for producing insulin, a hormone that regulates blood glucose levels. As a result, people with type 1 diabetes eventually need insulin medication because their beta cells can no longer produce the needed amounts.
Some of the common symptoms of type 1 diabetes include:
- Excessive thirst
- Frequent urination
- Excessive hunger
- Unexplained weight loss
- Fatigue
People are commonly diagnosed for the first time in childhood (which is why it used to be called “Juvenile Diabetes”), but there are also a lot of people who are diagnosed for the first time as adults. Anyone at any age can be impacted!
What causes type 1 diabetes?
The onset of type 1 diabetes is influenced by a combination of genetic and environmental factors. Scientists have long observed an association between microbes (bacteria or viruses) and the onset of type 1 diabetes. Some researchsuggests that certain infections may be linked to type 1 diabetes. Other data suggests that exposure to some microbes may actually help protect against type 1 diabetes onset. This shows that there are still many unknowns about the link between microbes and type 1 diabetes, and it likely varies based on the type of microbe being studied.
COVID-19 and type 1 diabetes
Evidence suggests that COVID-19 infection is associated with an increased risk of developing some types of autoimmune diseases. Since type 1 diabetes is autoimmune, it is possible this association extends to type 1. Many studies do find an increase in type 1 diabetes during the pandemic. The data is complicated though, because type 1 diabetes diagnoses were increasing prior to the pandemic. However, many studies , support that the increase is higher since 2020, but not all of the studies link COVID-19 to these higher rates.
For example, one study compared the rate of type 1 diabetes in patients who had COVID-19 versus those with other respiratory infections and found a higher rate in the COVID-19 group. A systematic review found an association between COVID-19 infection and multiple forms of diabetes, including type 1. Another study reported that COVID-19 infection might accelerate the progression of type 1 diabetes in pre-symptomatic individuals—children who had beta-cell-targeting antibodies but no symptoms when the study began. One study found that COVID-19 vaccination reduces the risk of multiple types of diabetes, including type 1, following an infection.
Other studies also find a rise in type 1 diabetes diagnoses since the pandemic was declared in 2020, but do not find an association specifically with having COVID-19.
Why is the data so mixed?
Interpreting these findings is challenging due to study limitations. For instance, studies relying on patients receiving a positive COVID-19 test result may misclassify patients who had undiagnosed or asymptomatic infections. Since researchers cannot control who does and does not get COVID-19, it is also possible those who get COVID are different in other ways that we don’t know. Other factors, such as differences in study design, sample sizes, participant demographics, geographic locations, and genetic backgrounds may also cause variations from study to study. This is why it is often challenging to study any autoimmune disease, there are many complex factors that come together to result in increased risk.
What we know so far and what we can do.
Type 1 diabetes cases were increasing before the pandemic, but the rate of new cases was higher after 2020. However, we need more information to know if the increase is due to COVID-19 infections.
We will update you as more data comes out. While we await this data you can take measures to reduce the risk of infection by using tools like vaccines, masking, ventilation, and hand washing.
Stay safe. Stay healthy.
Link to Original Substack Post
