Well, if you need another reason to get the COVID-19 vaccine, then it should be that the disease itself may increase the risk of type 1 diabetes. Along with many other long-term health issues, some people may develop type 1 diabetes after an acute COVID-19 infection.
I want to briefly discuss this consequence of the disease because the long-term healthcare issues resulting from a diagnosis of type 1 diabetes are deeply concerning.
What is type 1 diabetes?
Type 1 diabetes is an autoimmune disease that is characterized by autoreactive T lymphocytes (T-cells) that destroy pancreatic islet beta cells, which produce insulin. Essentially, these lymphocytes mistakenly attack the islet cells as if they were a foreign body, as they are supposed to do with a viral or bacterial infection.
In addition, regulatory T-cells (which are often called Tregs) modulate the immune system and would normally reduce the effect of an autoimmune attack. Tregs act like brakes that normally prevent mistaken attacks, like on the pancreatic islet cells, without affecting the whole immune system. A branch of diabetes research has suggested that abnormal Tregs could be the key to finding treatments to reverse type 1 diabetes.
Once the pancreatic islet cells are damaged, they no longer produce insulin, which is critical to regulating the levels of blood glucose. Without insulin, the blood glucose levels increase rapidly leading to long-term damage to eyesight, kidneys, limbs, heart, and other organs.
In fact, type 1 diabetes can be deadly if uncontrolled blood sugar leads to a life-threatening condition called diabetic ketoacidosis. Without regular insulin injections, a patient has little chance of living beyond a short period of time, and even then it could lead to a horrifically painful demise.
It is not known what causes this autoimmune disease, although there is strong evidence that genetics is the most important factor. However, other things may be implicated, like vaccine-preventable diseases, which could be important co-factors in the development of the disease. Just to be clear, vaccines are not linked to type 1 diabetes.
Currently, there are no known cures for type 1 diabetes. The only treatment for the disease is regular injections of human insulin, manufactured from genetically engineered E. coli cultures. In addition, careful diet and lifestyle management help regulate blood glucose levels, although it cannot replace insulin injections.
Just to be clear, type 2 diabetes is a substantially different disease from type 1. Mostly, type 2 diabetics produce insulin, just an insufficient amount to regulate glucose levels, or their cells have become resistant to insulin because of lifestyle issues. There is almost no relationship between type 1 and type 2 diabetes, except they share the same symptoms of high blood sugar.
What about COVID-19 and diabetes?
Two NIH-supported studies, both published in the peer-reviewed journal Cell Metabolism, confirmed that the SARS-CoV-2 virus can target and destroy the body’s insulin-producing beta cells. Furthermore,
Earlier lab studies provided evidence that the SARS-CoV-2 virus can infect human pancreatic beta cells. Moreover, researchers have shown that this virus can replicate in the beta cells and spread to other cells.
The latest work builds on these earlier studies to discover more about the connection between COVID-19 and diabetes. The work involved two independent NIH-funded teams, one led by Peter Jackson, Stanford University School of Medicine, Palo Alto, CA, and the other by Shuibing Chen, Weill Cornell Medicine, New York. I’m actually among the co-authors on the study by the Chen team, as some of the studies were conducted in my lab at NIH’s National Human Genome Research Institute, Bethesda, MD.
Both studies confirmed infection of pancreatic beta cells in autopsy samples from people who died of COVID-19. Additional studies by the Jackson team suggest that the coronavirus may preferentially infect the insulin-producing beta cells.
This also makes biological sense. Beta cells and other cell types in the pancreas express the ACE2 receptor protein, the TMPRSS2 enzyme protein, and neuropilin 1 (NRP1), all of which SARS-CoV-2 depends upon to enter and infect human cells. Indeed, the Chen team saw signs of the coronavirus in both insulin-producing beta cells and several other pancreatic cell types in the studies of autopsied pancreatic tissue.
The new findings also show that the coronavirus infection changes the function of islets—the pancreatic tissue that contains beta cells. Both teams report evidence that infection with SARS-CoV-2 leads to reduced production and release of insulin from pancreatic islet tissue. The Jackson team also found that the infection leads directly to the death of some of those all-important beta cells. Encouragingly, they showed this could avoided by blocking NRP1.
So given all of the evidence, the published research tells us:
- SARS-CoV-2 infects the insulin-producing cells of the pancreas.
- The virus causes damage or even death of these cells.
- And post-mortem inspection of these beta cells show the presence of the virus.
As many of us in the biomedical sciences like to say “correlation does not imply causation,” unless we can actually establish causation. We have a biologically plausible mechanism for how COVID-19 causes type 1 diabetes along with a lot of evidence of a link.
Type 1 diabetes is a chronic disease that can cause substantial long-term harm and death to an individual. Avoiding diabetes by doing everything you can to not catch the disease, like getting the COVID-19 vaccine and wearing masks,
The evidence is here. COVID-19 is linked to type 1 diabetes. Let me put it simply – you can choose a COVID-19 vaccine or a life time of injecting yourself with insulin 2-3 times a day to treat your diabetes. Seems like a simple choice.
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