Common viral infections linked to type 1 diabetes mellitus

Australian researchers say that children with type 1 diabetes mellitus are almost 10 times more likely to have enterovirus infection than children without the disease. The odds of infection also are higher in children diagnosed with prediabetes.

In their systematic review and meta-analysis of 26 case-control observational studies of 4,448 children and adults, the researchers found a clinically significant association between enterovirus infection and pancreatic islet autoimmunity (odds ratio [OR], 3.7) and clinical type 1 diabetes (OR, 9.8) as detected by molecular testing for enterovirus RNA or viral capsid protein in blood, stool, or tissue from patients with prediabetes and diabetes.

Type 1 diabetes is believed to originate from a complex interaction of genetic predisposition, the immune system, and environmental factors. Enteroviruses have long been studied as a possible environmental link. The researchers say that although their findings cannot prove that enteroviruses have a causal role in the development of diabetes, the results do support the direct evidence of enterovirus infection found in pancreatic tissue of persons with type 1 diabetes.

“There is a clinically significant association between enterovirus infection, detected with molecular methods, and autoimmunity/type 1 diabetes. Larger prospective studies would be needed to establish a clear temporal relation between enterovirus infection and the development of autoimmunity and type 1 diabetes,” the researchers conclude.

Yeung WC, Rawlinson WD, Craig ME. Enterovirus infection and type 1 diabetes mellitus: systematic review and meta-analysis of observational molecular studies. BMJ. 2011;342:d35.