Four out of a thousand children are currently diagnosed with type 1 diabetes – in just under 20 years the number will be twice as many. Cases of childhood diabetes have been increasing for a long time, but the number of cases increased again during the corona pandemic. It is quite possible that the Sars-CoV-2 coronavirus contributed directly to this.
“Many factors usually come together when diabetes develops – viruses can also be part of it,” said diabetologist Anette-Gabriele Ziegler, professor at the Technical University of Munich and director of the Institute for Diabetes Research at the Helmholtz Center Munich, during the SZ Health Forum on the topic “Children and diabetes – how good treatment works”. About ten out of every 1,000 children have a genetic predisposition to the disease; How many does it actually break out depends on a combination of environmental factors and lifestyle.
The coronavirus can infect the cells of the pancreas
The genes involved in diabetes are primarily those that affect the immune system. Because unlike type 2 diabetes, in which the pancreas is overloaded by poor nutrition and being overweight, type 1 diabetes is an autoimmune disease. The immune system attacks and destroys the beta cells in the pancreas, which produce the insulin that controls blood sugar. “But the patients only have a genetic disposition for this, i.e. a predisposition, it is not a matter of direct inheritance,” emphasized Ziegler, “more than 90 percent of children with diabetes have no relatives with this disease. So there must be other factors to be added.”
The importance of lifestyle became particularly clear after reunification: the frequency of diabetes in East Germany quickly matched the much higher numbers in West Germany up to that point. It goes without saying that nutrition plays a role in this. Nonetheless, no single food component was convicted as the culprit – neither sugar nor cow’s milk protein or banana protein. However, it has been shown that breastfeeding protects children. “But it’s not a guarantee,” said Olga Kordonouri, diabetologist and medical director of the “Auf der Bult” children’s and youth hospital in Hanover, during the SZ health forum. “A child can have been breastfed and still get diabetes.”
However, the possible contribution of viruses to the outbreak of the disease has now been established. Several pathways appear to play a role: 1. Some viruses infect and damage pancreatic beta cells, triggering autoimmune reactions that destroy the cells. 2. Some components of viruses resemble endogenous structures; Immune reactions against the viruses can therefore inadvertently also target the beta cells. 3. The virus infections are stressful for the body; the stress hormones released as a result, such as cortisol, are considered to be the antagonists of insulin. “As a result, the sugar levels in the blood rise, which can also be the trigger for the onset of developing diabetes,” said Kordonouri. According to Kordonouri, it is still unknown which of these mechanisms is responsible for the rapid increase in the number of type 1 diabetes during the pandemic. However, the Sars-CoV-2 coronavirus can infect cells directly – “so it could be that all three mechanisms play a role here.”
Parents often blame themselves when their children are diagnosed with diabetes. “But it’s nobody’s fault if type 1 diabetes develops,” emphasized Ziegler, “because it’s always a question of a combination of different factors.” Coincidence also plays a role.