- A new research report found that people with type 1 diabetes are 8 times more likely to have a disease caused by an enterovirus compared to people without diabetes.
- In T1D, the immune system attacks cells in the pancreas that produce insulin, a hormone used to regulate the body’s blood sugar levels.
- When there is not enough insulin, sugar levels tend to be uncontrolled, leading to the diagnosis of diabetes.
Type 1 diabetes and a shared virus family are strongly linked, new research finds. This adds to the mounting evidence that vaccines may play a role in diabetes prevention.
Researchers from Australia analyzed data and presented their findings at the European Association for the Study of Diabetes annual meeting in Stockholm, Sweden.
This comprehensive research report found that people with type 1 diabetes (T1D) are eight times more likely to have a disease caused by an enterovirus, a common family of viruses, compared to people without diabetes.
Type 1 diabetes is a condition most commonly diagnosed in children. It is the most common form of diabetes in children.
In recent decades, its incidence has increased, and while there is no direct link, there may be associations with enterovirus.
In T1D, the immune system attacks cells in the pancreas that produce insulin, a hormone used to regulate the body’s blood sugar levels. When there is not enough insulin, sugar levels tend to be uncontrolled, leading to the diagnosis of diabetes.
“Significant associations between enterovirus infection and type 1 diabetes have been published,” said Dr. Ambika Ashraf, director of pediatric endocrinology and diabetes at UAB and Children’s of Alabama and associate director of the UAB Comprehensive Diabetes Center in Birmingham, Alabama.
Ashraf was not part of the research review.
“Causality has not been established because it is difficult to obtain complete enterovirus genomes from patients at the time of T1D diagnosis,” Ashraf told Healthline.
Although the exact reason why the immune system attacks pancreatic cells is not fully understood, health experts believe it is caused by both genetics and an environmental trigger such as a virus.
“The contribution of these authors is that they have systematically searched the world literature and concluded that the enterovirus family are the leading candidates for such a role in causing type 1 diabetes. This is both provocative and challenging as numerous questions remain unanswered,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center in Tennessee, who was also not involved in the research review.
Schaffner told Healthline that there are many different enteroviruses, but the question is whether “they all have the ability to predispose to type 1 diabetes, or is this just limited to certain strains of enteroviruses?”
Understanding what viruses and how these viruses, which are predominantly found in the respiratory and intestinal tract, affect pancreatic function “would open the door to further avenues of prevention and treatment,” Schaffner told Healthline.
Enterovirus is a family of viruses that cause many of the upper respiratory symptoms that children face year-round. The Centers for Disease Control and Prevention
“Enteroviruses are a large class of viruses, including poliovirus, coxsackievirus, and echovirus. you cause [upper respiratory infection,] Hand, foot and mouth disease, aseptic meningitis, acute flaccid myelitis (EV-D68),” says Ashraf.
Enteroviruses circulate in communities and schools, causing upper respiratory symptoms such as sneezing, runny nose, body aches and occasionally fever.
School-age children are also more susceptible than adults because adults have previously been exposed to the virus to protect them.
Sonia Isaacs from the Department of Paediatrics in Child Health at the University of South Wales in Australia conducted the largest meta-analysis in this field, involving 12,077 participants from over 60 observational studies.
About half of the participants in this study had type 1 or islet autoimmunity, which typically progresses to type 1 diabetes. And these people are eight times more likely to get enterovirus infection than people without type 1 diabetes.
Similarly, people with type 1 diabetes were 16 more likely to have had enterovirus detected in the month they were diagnosed.
Ashraf agrees that while this study is compelling, parents should not be concerned about an increased risk of T1D.
“Enteroviruses are extremely common (much like the common cold), and the vast majority of those infected do not develop autoimmunity or T1D,” Ashraf said.
This information can help researchers understand whether vaccines can help lower rates of T1D.
If they can be used to reduce enterovirus infections, they can reduce the incidence of T1D.
“If it can be conclusively shown that a virus plays a role in causing type 1 diabetes, that raises the possibility that a vaccine could play a role in prevention,” Schaffner said.
Although no vaccines against the enterovirus are currently available, the US National Library of Medicine reports that several are underway, including the
“Unfortunately, no other enterovirus vaccines are available besides the poliovirus vaccine,” Ashraf told Healthline.
Despite being in a different family of viruses, research suggests that COVID-19 infections may also increase the risk of type 1 diabetes in children and adolescents. This leads to the idea that infection prevention can help prevent type 1 diabetes from occurring when viruses are a more potent cause of triggering T1D.
Schaffner promotes healthy habits for children to prevent the spread of contagious viruses such as enteroviruses. “Good hand hygiene is always important and if your child develops a fever or any abdominal discomfort, of course, consult your pediatrician or GP.”
Although it is not fully understood why the immune system attacks pancreatic cells and causes type 1 diabetes, the complication of diabetes is well documented.
Uncontrolled diabetes can lead to several life-threatening conditions in individuals. Diabetes increases the likelihood of heart disease, stroke, and kidney failure, and can even lead to blurred vision, numbness, and tingling in your fingers or toes.
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This increase in cases comes at a challenging time as there are barriers to T1D care such as: B. the availability and cost of insulin, strips, lancets, blood glucose monitoring and insulin pumps. “The implications of an increased incidence of T1D by 2040 are worrying, particularly in resource-constrained countries as the cost of care is prohibitive,” Ashraf warns.
Rajiv Bahl, MD, MBA, MS, is an emergency medicine physician and health journalist. You can find him under RajivBahlMD.com.
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