A new study from the CDC shows that children who have recovered from COVID-19 are at a significantly higher risk of type 1 or type 2 diabetes. I have written previously that COVID-19 might be linked to diabetes, but those studies were in adults. But this study shows that the risk of diabetes might be greater for children who had COVID-19.
This should be more reason for parents to make certain that their children are fully vaccinated against the disease. Diabetes is a lifetime disease that must be closely managed with insulin and, in the case of type 2 diabetes, various medications.
This post will review the research on children who have had COVID-19 and the risk of type 1 or type 2 diabetes.
What is 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.
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.
Both type 1 and type 2 diabetes are very dangerous diseases. Short- and long-term consequences of uncontrolled diabetes can be deadly. It is not a disease that anyone should dismiss lightly, and if you can reduce the risk of contracting diabetes by preventing children from getting COVID-19 with vaccines, then you should do that.
CDC paper on risk of diabetes in children who had COVID-19
In a paper from Sharon Saydah, Ph.D. and colleagues that was published in the CDC’s Morbidity and Mortality Weekly Report, researchers looked at two healthcare insurance claims databases that included 24 hospitals in 20 states between July and Dec. 9, 2021, during the period when the Delta variant was dominant. The study included patients <18 years old and who did not have pre-existing diagnoses of diabetes.
Their research found the following results:
- In one database, the researchers found a 2.6X increase in new diabetes cases among children who had recovered from COVID-19.
- In the second database, the study found a more modest 30% increase in new diabetes cases.
This study did not distinguish whether the diabetes was type 1 or type 2. Type 1 diabetes is not reversible, so it would probably be permanent. If the disease were type 2 diabetes, the study did not determine whether it was a temporary or chronic condition. In addition, because children were potentially more sedentary and more obese during the lockdown during the pandemic, it might increase the number of diabetes in children irrespective of COVID-19 infections.
However, 48.5% and 40.2% of the patients (in the two databases) were only diagnosed with diabetes after being treated for diabetic ketoacidosis which usually only occurs in type 1 diabetes. This is a pretty good piece of evidence that the majority, or possibly all, of the cases were type 1 diabetes. If this is borne out in more studies, this can be a serious concern for children who contract COVID-19.
Summary
In general, it was thought that children weren’t seriously affected by COVID-19. But this study shows a statistically significant increase in the risk of diabetes (type 1 or type 2) after for children recovering from COVID-19. We are not sure why it may happen, but preliminary evidence, at least for type 1 diabetes, seems to indicate that the virus attacks the insulin-producing cells of the pancreas.
Diabetes, whether type 1 or type 2, can be a chronic disease that has a significant impact on the overall health of the child. If there is any reason that I could propose to get your children vaccinated against COVID-19, it would be to make sure they don’t get diabetes.
Get the COVID-19 vaccine, protect your child.
Citations
- Barrett CE, Koyama AK, Alvarez P, Chow W, Lundeen EA, Perrine CG, Pavkov ME, Rolka DB, Wiltz JL, Bull-Otterson L, Gray S, Boehmer TK, Gundlapalli AV, Siegel DA, Kompaniyets L, Goodman AB, Mahon BE, Tauxe RV, Remley K, Saydah S. Risk for Newly Diagnosed Diabetes >30 Days After SARS-CoV-2 Infection Among Persons Aged <18 years — United States, March 1, 2020–June 28, 2021. MMWR Morb Mortal Wkly Rep. ePub: 7 January 2022. DOI: http://dx.doi.org/10.15585/mmwr.mm7102e2external icon
