Enterovirus linked to type 1 diabetes

A positive correlation exists between enterovirus infection in children and development of type 1 diabetes, a new study shows.

Researchers using 2000 to 2008 data from the national health insurance system of Taiwan found that children aged younger than 18 years who had had an enterovirus infection were 48% more likely to develop type 1 diabetes than uninfected children.

The retrospective cohort study matched 570,133 children who’d had an enterovirus infection with an equal number of uninfected controls. Infected children had an overall 5.73 per 100,000 incidence of type 1 diabetes compared with 3.89 per 100,000 for uninfected children, or an incidence rate ratio of 1.48. Children aged older than 10 years had a greater risk of diabetes than younger children.

Type 1 diabetes is known to arise from a complex interplay between genetic predisposition, the immune system, and environmental influences. Although research has clarified the significant role of genetics, the impact of environmental variables isn’t well understood, the investigators say. The incidence of type 1 diabetes has grown markedly worldwide and isn’t explained by genetics alone, increasing the importance of studying environmental triggers, they add.

AAP 2014: Chest pain and syncope: Is it fatal? 

Enteroviruses, especially coxsackievirus B, have long been implicated as contributors to type 1 diabetes, but their role is “far from established,” the researchers note. They conclude that their study shows a positive correlation between enterovirus infection and type 1 diabetes in children aged younger than 18 years, which, although observational, is “solid enough to guide further research.”

They also suggest that vaccinating children against enterovirus infection might impede the growth of type 1 diabetes.

To get weekly clinical advice for today's pediatrician, subscribe to the Contemporary Pediatrics PediaMedia.