I have written other articles about the link between COVID-19 and diabetes, and now a new study has been published that shows an increase in new diagnoses of type 1 diabetes among children at one institution. Although it only included data from one healthcare institution, it represents more troubling data that COVID-19 may be closely linked to new cases of type 1 diabetes.
Let’s take a look at this new paper and determine what it tells us.
COVID-19 pandemic and diabetes — paper
The paper, by Jane Kim MD, University of California San Diego, and colleagues, was published 24 January 2022 in JAMA Pediatrics. They identified children admitted to Rady Children’s Hospital-San Diego, the tertiary care center for children in San Diego, California, and surrounding counties in a cross-sectional study.
From March 2020 through March 2021, a total of 187 children were admitted for new-onset type 1 diabetes, an autoimmune disease that destroys the insulin-producing cells of the pancreas, compared to 119 cases from March 2019 through February 2020, prior to the pandemic. This was a 57% increase in cases.
For part of the pandemic period, July 2020 to February 2021, the researchers found significantly more new diagnoses than they had predicted based on averages from the previous 5 years. They estimated that there should have been 10 new diagnoses in February 2021, but there were actually 21.
Furthermore, 50% of those cases presented with diabetic ketoacidosis (DKA), a life-threatening condition caused by uncontrolled type 1 diabetes. This compares with the average of 41% over the prior 5 years.
Despite the noted increase in DKA frequency, the researchers observed no significant difference in the percentage of kids that needed to be admitted to pediatric intensive care (8.6% during the pandemic vs 6.4% in the years prior), nor were there differences in average age at presentation (9.6 vs 9.7 years, respectively), BMI z-score (-0.39 vs -0.43), or HbA1c levels (11.6% vs 11.7%).
This study had some weaknesses:
- Although all children admitted to the hospital were tested for COVID-19, they were not tested for previous infections. This information could have really helped show a correlation between the disease and type 1 diabetes.
- The study only included one hospital in San Diego, so it lacked broad demographic groups which are important for studies of this sort. However, it is the only children’s hospital in the greater San Diego, and the authors stated, “we routinely admit children with new-onset diabetes who require initiation of insulin treatment, and we monitor almost all patients newly diagnosed with type 1 diabetes.”
The authors concluded:
In agreement with other studies, we observed a significant increase in the frequency of DKA at the time of T1D diagnosis during the COVID-19 pandemic.
Although this was an observational study at just one hospital, it provides more solid evidence that something is going on between COVID-19 and a substantial increase in risk for type 1 (and, based on other studies, type 2)
So if you need more reason to make sure that your children are fully vaccinated against COVID-19, this should be it. Type 1 diabetes is not a trivial disease — there is no cure, and it requires a lifetime of insulin injections and medical care.
In this case, the vaccine literally can save lives.
- Gottesman BL, Yu J, Tanaka C, Longhurst CA, Kim JJ. Incidence of New-Onset Type 1 Diabetes Among US Children During the COVID-19 Global Pandemic. JAMA Pediatr. 2022 Jan 24. doi: 10.1001/jamapediatrics.2021.5801. Epub ahead of print. PMID: 35072727.
- Reiterer M, Rajan M, Gómez-Banoy N, Lau JD, Gomez-Escobar LG, Ma L, Gilani A, Alvarez-Mulett S, Sholle ET, Chandar V, Bram Y, Hoffman K, Bhardwaj P, Piloco P, Rubio-Navarro A, Uhl S, Carrau L, Houhgton S, Redmond D, Shukla AP, Goyal P, Brown KA, tenOever BR, Alonso LC, Schwartz RE, Schenck EJ, Safford MM, Lo JC. Hyperglycemia in acute COVID-19 is characterized by insulin resistance and adipose tissue infectivity by SARS-CoV-2. Cell Metab. 2021 Nov 2;33(11):2174-2188.e5. doi: 10.1016/j.cmet.2021.09.009. Epub 2021 Sep 16. Erratum in: Cell Metab. 2021 Dec 7;33(12):2484. PMID: 34599884; PMCID: PMC8443335.
- Zickler M, Stanelle-Bertram S, Ehret S, Heinrich F, Lange P, Schaumburg B, Kouassi NM, Beck S, Jaeckstein MY, Mann O, Krasemann S, Schroeder M, Jarczak D, Nierhaus A, Kluge S, Peschka M, Schlüter H, Renné T, Pueschel K, Kloetgen A, Scheja L, Ondruschka B, Heeren J, Gabriel G. Replication of SARS-CoV-2 in adipose tissue determines organ and systemic lipid metabolism in hamsters and humans. Cell Metab. 2022 Jan 4;34(1):1-2. doi: 10.1016/j.cmet.2021.12.002. Epub 2021 Dec 10. PMID: 34895500; PMCID: PMC8663969.
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