Does COVID-19 predispose patients to type 1 diabetes          mellitus?

Ata, Aysun; Jalilova, Arzu; Kirkgöz, Tarık; Işıklar, Hafize; Demir, Günay; Özkan, Behzat; Zeytinlioğlu, Ayşin; Darcan, Şükran; Özen, Samim; Gökşen, Damla

doi:10.1297/cpe.2021-0050

Cited by 21 publications

(19 citation statements)

References 20 publications

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“…This consistent percentage of patients was however not significantly different respect to that found in healthy controls without diabetes collected in the same pandemic period of time (8.4%). Our data confirm the results of other studies [ 3 , 9 , 10 ], where no significantly different SARS-CoV-2 antibody frequencies were found between T1D patients and healthy controls. Salmi et al [ 10 ], with a baseline prevalence of their own region of 0.6%, did not detect SARS-CoV-2 antibodies in any of the 20 newly diagnosed T1D children recruited in the pandemic period April–October 2020.…”

Section: Discussionsupporting

confidence: 92%

“…However, to date, no compelling evidence emerged to confirm a role of COVID-19 as a potential trigger of T1D, and it remains unclear whether there is a causal role of SARS-CoV-2 infection in a change of diabetes incidence. In particular, to our knowledge, no data are available on the effects of COVID-19 infection on the development of T1D autoimmunity and few, discordant information are available on SARS-CoV-2 antibody frequencies at diagnosis of T1D during pandemic, with percentages of positive patients ranging from 0 to 19% [ 3 , 8 – 10 ]. Based on these considerations and to gain new insights on the relationship between COVID-19 and T1D, aims of our study were:…”

Section: Introductionmentioning

confidence: 99%

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No effects of COVID-19 on the development of type 1 diabetes autoimmunity and no evidence of an increased frequency of SARS-CoV-2 antibodies in newly diagnosed type 1 diabetes patients relative to healthy subjects

Tiberti,

Nenna,

Tromba

et al. 2023

Acta Diabetol

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Aims To evaluate the relationship between SARS-CoV-2 infection and autoimmunity in type 1 diabetes (T1D) and SARS-CoV-2 antibodies frequency at diagnosis of T1D during pandemic. Methods The presence of T1D-specific autoimmunity was evaluated in a cohort of 99 children and adolescents without diabetes that contracted SARS-CoV-2 infection. Moreover, the frequency of IgM- and IgG-SARS-CoV-2 antibodies was evaluated in 41 newly diagnosed T1D patients not yet vaccinated against SARS-CoV-2 disease, collected during the pandemic, compared to healthy subjects (CTRL). Results None of the 99 patients that contracted SARS-CoV-2 infection during the pandemic period was found positive for T1D autoantibodies. The frequency of SARS-CoV-2 antibodies was not significantly different in patients newly diagnosed with T1D (12.2%), compared with CTRL (8.4%). Among SARS-CoV-2 antibody positive T1D patients, 80% were target of diabetes autoantibodies and 60% had another concomitant autoimmune disease. Among the CTRL subjects positive for SARS-CoV-2Abs (n = 10), none was found positive for T1D autoantibodies. Conclusions The results of the present study do not confirm, at least in the short term, a role of COVID-19 as a potential trigger of T1D autoimmunity and do not provide evidence of an increased frequency of SARS-CoV-2 antibodies in newly diagnosed T1D patients in comparison with healthy population.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

No effects of COVID-19 on the development of type 1 diabetes autoimmunity and no evidence of an increased frequency of SARS-CoV-2 antibodies in newly diagnosed type 1 diabetes patients relative to healthy subjects

Tiberti,

Nenna,

Tromba

et al. 2023

Acta Diabetol

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“…The SARS-CoV2 antibody test was positive in 3 patients with T1D and 6 controls, therefore demonstrating that the positivity rate did not significantly differ between the two groups. Thus, our data did not support a clear association between previous SARS-CoV2 infection and T1D onset, similarly to previous reports ( 53 ). ( Figure 5 ) Not only infectious agents but also psychosocial stressors are known to play a fundamental role in the pathophysiology of T1D initiation, since several physical catastrophic events have been reported to be followed by an increased number of newly diagnosed cases of T1D ( 54 , 55 ).…”

Section: Discussionsupporting

confidence: 73%

Stress hyperglycemia, Diabetes mellitus and COVID-19 infection: The impact on newly diagnosed type 1 diabetes

Farakla

Lagousi

Miligkos

et al. 2022

Front. Clin. Diabetes Healthc.

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Several recent studies have documented an increased incidence of newly diagnosed type 1 Diabetes (T1D) cases in children and adolescents during the COVID-19 pandemic and a more severe presentation at diabetes onset. In this descriptive study, we present the experience of the Diabetes Centre of the Division of Endocrinology, Diabetes, and Metabolism of the First Department of Pediatrics of the National and Kapodistrian University of Athens Medical School at “Aghia Sophia” Children’s Hospital in Athens, Greece, concerning new cases of T1D diagnosis during the COVID-19 pandemic (March 2020- December 2021). Patients who had already been diagnosed with T1D and needed hospitalization due to poor control during the pandemic have been excluded from this study. Eighty- three children and adolescents with a mean age of 8,5 ± 4.02 years were admitted to the hospital due to newly diagnosed T1D during this 22 months’ period in comparison to 34 new cases in the previous year. All patients admitted during the pandemic with a new diagnosis of T1D, presented in their majority with DKA (Ph: 7.2) representing an increase of new severe cases in comparison to previous years (Ph 7.2 versus 7.3, p value: 0.021, in the previous year), [p-value: 0.027]. 49 cases presented with DKA, of which 24 were characterized moderate and 14 severe DKA (28.9% and 16,9%, respectively), while 5 patients newly diagnosed, needed to be admitted to the ICU to recover from severe acidosis. Whether a previous COVID- 19 infection could have been the triggering factor is not supported by the SARS-Cov2 specific antibodies analysis in our cohort of patients. As far as HbA1c is concerned there was no statistically significant difference between the pre COVID-19 year and the years of the pandemic (11.6% versus 11.9%, p- value: 0.461). Triglycerides values were significantly higher in patients with new onset T1D during COVID-19 years compared to those before the pandemic (p value= 0.032). Additionally, there is a statistically significant correlation between Ph and Triglycerides for the whole period 2020-2021 (p-value<0.001), while this correlation is not significant for the year 2019. More large- scale studies are required to confirm these observations.

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“…Apart from COVID-19, the annual mortality rate for diabetic ketoacidosis is approximately 5%, which may explain why diabetic patients have higher mortality rates with COVID-19 than patients without diabetes [46]. In a study of 106 pediatric patients with a recent diagnosis of T1DM, 58.5% had diabetic ketoacidosis at baseline; when matched to control patients without T1DM, it was found that the incidence of COVID-19 infection was similar in both groups although the incidence of diabetic ketoacidosis was higher in the T1DM patients [47].…”

Section: Diabetic Ketoacidosismentioning

confidence: 99%

Exploring the Implications of New-Onset Diabetes in COVID-19: A Narrative Review

Pergolizzi¹,

LeQuang²,

Breve³

et al. 2023

Cureus

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Post-viral new-onset diabetes has been an important feature of the COVID-19 pandemic. It is not always clear if new-onset diabetes is the unmasking of a previously undiagnosed condition, the acceleration of prediabetes, or new-onset diabetes that would not have otherwise occurred. Even asymptomatic cases of COVID-19 have been associated with new-onset diabetes. Diabetes that emerges during acute COVID-19 infection tends to have an atypical presentation, characterized by hyperglycemia and potentially lifethreatening diabetic ketoacidosis. It is not always clear if new-onset diabetes is type 1 or type 2 diabetes mellitus. Many cases of COVID-associated diabetes appear to be type 1 diabetes, which is actually an autoimmune disorder. The clinical course varies temporally and with respect to outcomes; in some cases, diabetes resolves completely or improves incrementally after recovery from COVID-19. Disruptions in macrophagy caused by COVID-19 infection along with an exaggerated inflammatory response that can occur in COVID-19 also play a role. Those who survive COVID-19 remain at a 40% elevated risk for diabetes in the first year, even if their case of COVID-19 was not particularly severe. A subsequent post-pandemic wave of new diabetes patients may be expected.

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Does COVID-19 predispose patients to type 1 diabetes mellitus?

Cited by 21 publications

References 20 publications

No effects of COVID-19 on the development of type 1 diabetes autoimmunity and no evidence of an increased frequency of SARS-CoV-2 antibodies in newly diagnosed type 1 diabetes patients relative to healthy subjects

No effects of COVID-19 on the development of type 1 diabetes autoimmunity and no evidence of an increased frequency of SARS-CoV-2 antibodies in newly diagnosed type 1 diabetes patients relative to healthy subjects

Stress hyperglycemia, Diabetes mellitus and COVID-19 infection: The impact on newly diagnosed type 1 diabetes

Exploring the Implications of New-Onset Diabetes in COVID-19: A Narrative Review

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