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Enterovirus Infection and Type 1 Diabetes

A new study found enterovirus infection increased the risk of type 1 diabetes in children…

Doctors in Taiwan have found evidence that links enterovirus infection or EV (poliovirus, Coxsackievirus A and B, echovirus) and type 1 diabetes in children. Previous studies have shown an association between EV infection and type 1 diabetes, however, the studies were limited due to small sample sizes.

Using Taiwan’s national health insurance system, the authors looked at data from 2002-2008 for children aged 18 years or younger who were diagnosed with type 1 diabetes, and also previously diagnosed with some form of enterovirus infection. A total of 570,133 children were in the EV group and 570,133 in non-EV group.

In the results, the incidence of type 1 diabetes was higher in the enterovirus infection group than in the non-enterovirus infection group (5.73 vs 3.89 per 100,000 person-years). The hazard ratios of type 1 diabetes in children with allergic rhinitis, bronchial asthma or any atopic diseases showed low incidence of type 1 diabetes than those without it. Also, the data showed that among children without EV, incidence increased with age.

In conclusion, the researchers found a positive connection between type 1 diabetes and EV infection in children younger than 17 years. The authors suggest that an effective vaccine against EV infection may reduce the incidence of type 1 diabetes. The study has several limitations including no confirmation on the virus culture therefore the diagnoses of EV infection are based on clinical phenotypes. Also, the age of onset for type 1 diabetes is not limited to this age group. The study also did not clarify exactly how enterovirus infection causes type 1 diabetes.

Practice Pearls:

  • Enterovirus infection increased the risk for the development of type 1 diabetes.
  • How enterovirus infection leads to type 1 diabetes is still unknown.
  • The results suggest that vaccination against EV might reduce the incidence of type 1 diabetes.


T. Li, et al. “Enterovirus infection is associated with an increased risk of childhood type 1 diabetes in Taiwan: a nationwide population-based cohort study.” Diabetologia. 2014.