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Two conference abstracts presented at the European Association for the Study of Diabetes Annual Meeting 2022, look at COVID-19 infection and incidence of Type 1 diabetes in young people.
Rachel Connor, JDRF U.K Research Partnership Director, said:
“The scientific hunt to identify what is causing the global growth in type 1 diabetes is critically important because every diagnosis of this life-threatening condition turns a person’s life upside down.
“These studies both use national registry data, and as such have good sample sizes. The difference in reported conclusions lies in interpretation of the data and the factors that have been considered in the analysis
“The Norwegian study showed a possible association between COVID and new onset type 1 diabetes. However, the authors are clear that a potential associated link does not prove cause and effect and they also point to the effects of lockdowns may have led to delays in seeking treatment and diagnosis.
“In the Scottish Study, the authors found that any increase in incidence was more likely to be explained increased testing around the time of diabetes testing and that having COVID precipitated rather than caused type 1 diabetes in those people who were already developing the condition. This study also warns against there being a causal effect.
“Therefore, as with much medical science, more research needs to be done in order to reach a definitive scientific conclusion.
“There is still so much that is unknown about the causes of type 1, in particular the interplay between genes, certain types of viruses and environmental factors.
“As the world becomes used to COVID being an ever-present virus, these two studies are an important step in starting to assess whether COVID could have a potential impact on auto-immune conditions such as type 1 diabetes.
“One point is very clear: the need for everyone to know the four ‘T’ symptoms of type 1 diabetes for an early diagnosis and prompt treatment: needing the toilet more, being thirstier, becoming thinner and more tired. This knowledge in itself could be lifesaving.”
Dr Jamie Hartmann-Boyce, Associate Professor at the Nuffield Department of Primary Care Health Sciences, University of Oxford, said:
“Two new studies present conflicting conclusions as to whether covid-19 increases the risk of type 1 diabetes in young people. Both teams of scientists attempt to take a range of factors into account in their analyses, but due to the nature of the available data, much remains unknown. Covid testing, particularly at the start of the pandemic, was not widespread in young people, and type 1 diabetes is also not regularly tested for, which makes it hard to establish if one could cause the other. Though there are a number of credible reasons why covid-19 might lead to development of type 1 diabetes, this remains in no way proven. Increased testing at time of infection and delays in seeking care could possibly explain the links observed. It is also possible that other factors which occurred during the pandemic – including behavior of other viruses linked to type 1 diabetes, and changes in exposure to vitamin d from less time spent outdoors, could lead to an increase in cases. More data is needed at the population level, to see if there is a sustained rise in type 1 diabetes since the start of the pandemic, and if this is correlated with rates of SARS-CoV-2 infections in communities. More lab studies are also needed to better understand the impact of SARS-CoV-2 on pathways contributing to type 1 diabetes.”
Dr Gareth Nye, Senior Lecturer at the University of Chester, said:
“Both press releases are of great interest for separate reasons however we must take both with caution. There has been a rise in miscommunication surrounding conference abstracts particularly in relation to COVID 19 which has had long lasting effects on science communication on the whole.
“At the point of conference abstract submission, we usually expect they have not been held up to scrutiny within the wider scientific field and without the full peer reviewed study being published, those questions may not be answered. In the case of the study from Colhoun et Al this has been additionally published leading to greater faith in the presented data from this source.
“Despite this, both studies on the face of it appear to show good scientific process and there is no reason to suggest the findings are not accurate, regardless of the contradictions presented.
“Here we see two separate populations studies with slightly different approaches to this which in itself it bound to show differences in results and without the full detail we can not be certain why we see the opposite findings. What we can be sure of is that COVID 19 as a disease is still vastly misunderstood and we have much work to do to uncover the full role it has to play in disease development as with Type 1 diabetes.
“The finding that a novel virus may increase risk of type 1 diabetes is not surprising considering the current knowledge pool however the risk reported in both cases is still incredibly small and the vast majority of the population will not develop the condition however, with lockdown procedures in place in the reported countries we may be seeing an artefact of children being around parents or guardians for a greater proportion of time, with a heightened sense of concern brought about from the pandemic which is why children are being diagnosed so close to a positive test.”
“SARS-CoV-2 infection and subsequent risk of type 1 diabetes in 1.2 million children”, by Hanne Løvdal Gulseth et al; and “Relation of Incident Type 1 Diabetes to Recent COVID-19 Infection: Cohort Study Using e-Health Record Linkage in Scotland”, by Xiaying Li et al; Presented at the European Association for the Study of Diabetes Annual Meeting 2022
Declared interests
Dr Jamie Hartmann-Boyce: “I’ve received funding from the World Health Organization, British Heart Foundation, Cancer Research UK, and the NIHR, all on topics not related to this one. I have type 1 diabetes and have written about this topic for The Conversation UK.”
Dr Gareth Nye: “No DOI.”
For all other experts, no reply to our request for DOIs was received.