COVID-19 linked to up to 72% increase in newly diagnosed type 1 diabetes among adolescents

Children who have been infected with COVID-19 are at significantly higher risk of developing type 1 diabetes (T1D), according to a new study that analyzed electronic medical records from more than 1 million patients aged 18 and younger fall ill.

In a study published today in the journal JAMA network openResearchers at Case Western Reserve University School of Medicine report that children and adolescents who contracted COVID-19 were more susceptible to developing T1D in the six months following their COVID diagnosis.

The results showed a 72% increase in new diagnoses of T1D in COVID-19 patients aged 18 and younger, although the research emphasized that it is unclear whether COVID-19 triggers the recurrence of T1D.

According to the Centers for Disease Control and Prevention (CDC), approximately 187,000 children and adolescents under the age of 20 are living with T1D nationwide.

“Type 1 diabetes is considered an autoimmune disease,” said Pamela Davis, Distinguished University Professor and The Arline H. and Curtis F. Garvin Research Professor at Case Western Reserve School of Medicine, a corresponding author on the study. “It mainly occurs because the body’s immune defenses attack the cells that produce insulin, stopping insulin production and causing the disease. It has been suggested that COVID enhances autoimmune responses, and our current results reinforce this suggestion.”

The team analyzed the anonymized electronic medical records of nearly 1.1 million patients ages 18 and younger in the United States and 13 other countries who were diagnosed with SARS-CoV-2 infection between March 2020 and December 2021, as well as of patients diagnosed with SARS-CoV-2 infection -COVID-related respiratory infection in the same period.

The study population was further divided into two groups: patients up to 9 years of age and patients 10 to 18 years of age. After careful statistical matching, accounting for age, demographics, and family history of diabetes, there were 285,628 in each group for a total of 571,256 patients.

study results

The research team found that among more than 571,000 pediatric patients:

  • Within six months of SARS-CoV2 infection, 123 patients (0.043%) had received a new diagnosis of T1D, compared with 72 patients (0.025%) who had received a new diagnosis following non-COVID respiratory tract infection, which a 72% increase corresponds to new diagnoses.
  • At one, three and six months post-infection, the risk of a T1D diagnosis was significantly higher in SARS-CoV2 infected than in non-COVID respiratory infections. Similar results have been reported in patients in the 9 year old and 10 to 18 year old age groups.

“Families with a high risk of type 1 diabetes in their children should be particularly vigilant for symptoms of post-COVID diabetes, and pediatricians should be alert to an influx of new cases of type 1 diabetes, particularly as the Omicron variant of COVID spreads it’s spreading so quickly among them kids,” Davis said. “We could see a significant increase in this disease over the coming months to years. Type 1 diabetes is a lifelong challenge for those who suffer from it, and increased incidence means a significant number of children are affected.”

Rong Xu, also corresponding author, professor of biomedical informatics at the School of Medicine and director of the Center for Artificial Intelligence in Drug Discovery, said more research is needed to examine whether the increased risk of T1D recurrence after a SARS-CoV2 infection will persist in pediatric patients who are susceptible and how to treat COVID-19 associated T1D in children.

“We are also investigating possible changes in the development of type 2 diabetes in children after SARS-CoV2 infection,” Xu said.

T1D is most common in children, while type 2 diabetes (T2D) is known as “adult-onset diabetes” and develops over time, often when the patient becomes resistant to the effects of insulin and later when the pancreas stops enough insulin produced to the CDC.

The Case Western Reserve research team also included David Kaelber, professor of internal medicine, pediatrics and population and quantitative health sciences, and medical students Ellen Kendall and Veronica Olaker.

Previous COVID-related studies led by the CWRU team have found that the risk factor for Alzheimer’s disease increases by 50-80% in older adults who have contracted COVID, and that people with dementia are twice as likely to have COVID fall ill.


Case Western Reserve University

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