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Increased risk of Type 1 diabetes in children after COVID-19

A new study has just been published that shows that children who have contracted COVID-19 are at a much higher risk of developing type 1 diabetes. Here is just one more reason to get the COVID-19 vaccine.

I have written a few articles about the link between COVID-19 and diabetes. I think we’ve reached the point where there is little doubt that COVID-19 can cause diabetes, including in children.

As I usually do, I will review the data from this research and explain what it all means scientifically and medically. Spoiler alert, this is fairly strong evidence that supports a link between COVID-19 and diabetes in children.

diabetes COVID children

What is diabetes?

Type 1 diabetes is an autoimmune disease that is characterized by the appearance of autoreactive T lymphocytes (T-cells) that destroy pancreatic islet beta cells, which are the only cells in the body that 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.

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 uncontrolled diabetes will 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 1 diabetes is a lifetime disease, not one that will disappear in a few years.

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. These lifestyle issues may include obesity, lack of exercise, and diet. However, there also appears to be a genetic component because there are individuals who have a “good” lifestyle who will still contract type 2 diabetes.

There is almost no relationship between type 1 and type 2 diabetes, except they share the same symptoms of high blood sugar.

two test tubes
Photo by Martin Lopez on

Type 1 diabetes and COVID-19 in children research paper

In a paper published on 22 May 2023 in the respected JAMA, Ezio Bonifacio, Ph.D., Center for Regenerative Therapies Dresden, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany, and colleagues examined medical records of all children born between 2010 and 2018 in Bavaria. The incidence rate of type 1 diabetes and diagnoses of COVID-19 was compared in 2018-2019 vs 2020-2021.

The researchers examined medical claims data of 1,181,878 children, of which 1,242 received a diagnosis of type 1 diabetes through December 2019 (just before the start of the pandemic). Of the remaining 1,180,636 children without a prior type 1 diabetes diagnosis at the start of 2020, 195,795 (16.6%) had a COVID-19 diagnosis between January 2020 and December 2021.

Here are the key results:

  • The incidence rate of type 1 diabetes was 29.9 per 100,000 person-years between January 2020 and December 2021 vs 19.5 per 100,000 children between January 2018 and December 2019.
  • The incidence rate of type 1 diabetes in children during the pandemic was 28.5 cases per 100,000 person-years in the absence of a COVID-19 diagnosis.
  • The incidence rate of type 1 diabetes in children was 55.2 per 100,000 in the same quarter as the COVID-19 diagnosis.

Based on this data, there appears to be a nearly doubled incidence of type 1 diabetes diagnosis in children who had a diagnosis of COVID-19.

The authors wrote, “Possible mechanisms include initiation of autoimmunity or acceleration of disease progression.” In other words, COVID-19 might be the trigger that I discussed above that starts type 1 diabetes.


I think the evidence that COVID-19 is linked to both type 1 and type 2 diabetes has become overwhelming. This study shows that children who contract COVID-19 have nearly a double risk of type 1 diabetes, a disease that is permanent and can lead to premature death.

This is just another reason to have children vaccinated against COVID-19, even though COVID-19 is not as serious for children as it is for adults and seniors. The risk of type 1 diabetes should scare any parent into making sure they do everything to prevent COVID-19.

This is a powerful study that gets four out of five stars. I would give it five stars but it only includes children in one part, Bavaria, of one country, Germany. There might be confounders that bias the data. I’d give a study that examined a wider demographic group a full five stars.

Nevertheless, this study, along with several others, convinces me that there is a link between a COVID-19 diagnosis and type 1 diabetes in children. Get the vaccine, it’ll save your child’s life.


Michael Simpson

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