There has been a significant global increase in the diagnosed incidence of type 1 diabetes (T1D) among children and adolescents since the Covid-19 pandemic. During the pandemic, there was a significant strain on health services, which meant the capacity for testing and diagnosing diseases was limited. This created a backlog of cases to be diagnosed once the pandemic was over. However, researchers do not believe this is the sole cause for the increase in incidence, as Covid-19 has been discovered to be a major risk factor for T1D.
Individuals with T1D do not produce enough of a hormone called insulin, which controls blood glucose levels. The condition often arises in childhood but can occur at any age. Typically, children with T1D present with increased fatigue, tiredness, thirst, increased urination, and unexplained weight loss. It is important that T1D is diagnosed promptly, as it can be fatal if it is left untreated. Once diagnosed, individuals will rely on insulin injections to stabilise their blood glucose for the remainder of their lives.
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According to the UK’s leading diabetes charity, Diabetes UK, cases of T1D were increasing by approximately 3% each year prior to the pandemic. This number increased significantly to 14% in the first year of the pandemic (2020), followed by a further 27% increase in cases in the second year (2021). Since the acute phase of the pandemic, we have been learning about the various health impacts of Covid-19. There is a significant association between viral infections and T1D development and progression. The significant increase in T1D incidence during the pandemic suggests that infection with Covid-19 may trigger the development of T1D.
An article published in The Journal of Clinical Endocrinology & Metabolism in March 2023 by Yichen Wang and colleagues evaluated the mechanisms that could be responsible for stimulating the autoimmune response that triggers T1D after Covid-19 infection. Virus-induced β-cell damage, immune-mediated loss of pancreatic β cells, and damage to β cells from the infection of surrounding cells were considered possible mechanisms that could lead to T1D. However, given that the development of T1D is often a chronic, long-term process, it is currently difficult to draw firm conclusions about whether SARS-CoV-2 causes T1D. More in-depth and comprehensive studies with larger cohorts of patients and long-term clinical follow-ups are essential to understanding if and how the autoimmune mechanisms stimulated by Covid-19 infection are responsible for the surge in T1D incidence.
Initially, GlobalData epidemiologists forecast that there would be 33,100 diagnosed prevalent cases of T1D among children and adolescents (ages 0–19 years) in the UK in 2023, which was expected to increase to 33,800 diagnosed prevalent cases by 2029. However, the initial GlobalData forecast did not anticipate changes in incidence as a consequence of the Covid-19 pandemic. If the incidence continues to increase as it has since the pandemic, it is likely there will be many more cases than initially forecast by 2029.
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