New study: Virus of importance in the development of type 1 diabetes

Particularly sensitive age

The researchers studied the development of diabetes-related autoantibodies and antibodies against the coronavirus in 885 children in Germany, Poland, Sweden, and Great Britain, aged four months old and two years old during the period of April 2018 until June 2022. Out of the children, 170 developed antibodies against the coronavirus during the period, which suggests they had had Covid-19.

The children who had had a Covid-19 infection had an approximately twofold risk of developing diabetes-related autoantibodies compared to the children that had not been infected by the virus. The study also shows that the increase in the risk was higher in children who had the infection before 18 months of age, and it was the highest in children who were around 12 months old when they had Covid-19.

“Children that were infected at age one had around five to ten times as high a risk of developing diabetes-related autoantibodies compared to children of the same age who were not infected. The results indicate that children with a genetic risk of type 1 diabetes are particularly sensitive to certain viral infections at that age”, says Ezio Bonifacio, professor at the TUD Dresden University of Technology who led the study.

Certain viral infections

Previous research has shown that there is a connection between enterovirus infection and the development of autoantibodies and type 1 diabetes. The researchers behind the new study also followed up antibodies for the influenza virus but found no connection between influenza virus and the development of diabetes-related autoantibodies. This indicates that certain viruses seem to be of importance in the development of type 1 diabetes.

“The study adds to the evidence base that there is a connection between certain viral infections and the development of diabetes-related autoantibodies, which are used to identify individuals who are at risk of developing type 1 diabetes later in life. At the same time, a lot of research suggests that several factors interact in the development of type 1 diabetes. Our new study is a piece in the jigsaw puzzle we are completing in our effort to understand the disease”, says Helena Elding Larsson.

Important to train the immune system

Humans carry the immune system cells from birth, and these cells develop when we are exposed to viruses and bacteria. Most viruses are harmless, but some may lead to serious illness. Helena Elding Larsson still wants to emphasise that small children need to be exposed to viruses to strengthen their immune system.

“In most cases, parents of small children should not fear viruses, regardless of whether the child has an increased risk of developing type 1 diabetes or not. Children need to have infections and develop their immune system. It may become evident that we should protect children at higher risk of type 1 diabetes from certain viruses that increase the risk of getting the disease, but first we need to perform vaccination studies to draw safe conclusions and develop new treatments”, says Helena Elding Larsson.

Link to the study in the journal JAMA: SARS-CoV-2 Infection and Development of Islet Autoimmunity in Early Childhood | Infectious Diseases | JAMA | JAMA Network

The POInT study

• The POInT study is investigating if the development of type 1 diabetes can be prevented in children with an increased risk of the disease by preventive oral insulin treatment. The children enter the study at the age of four to seven months and partake in regular examinations where the researchers follow the development of diabetes-related autoantibodies. In type 1 diabetes, the body’s immune system has attacked the beta cells of the pancreas so that they can no longer produce insulin.
• The researchers want to investigate if they can train a child’s immune system to better tolerate the insulin produced by the body to prevent the immune system of destroying the beta cells. Within POInT, researchers are also investigating the relationship between diabetes-related autoantibodies and viruses, for example.
• Facts about the study: Subject: Type 1 diabetes, etiology, virus research Study design: Researcher-initiated study. Number of participants in the study: 885 children with increased risk of type 1 diabetes
• Funding: The POInT study is funded by The Leona M. and Harry B. Helmsley Charitable Trust, USA, and Helmholtz Munich, Germany. The study has also received funding from the Wellcome Trust, JDRF, and the German Diabetes Center (DDZ). The Swedish POInT study receives funding from Barndiabetesfonden.