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Research from Taiwan adds to growing evidence suggesting that type 1 diabetes may result from an enterovirus infection.

Risk increased by nearly 50%

The study, carried out by researchers from China Medical University in Taiwan, reviewed data from insurance claims from Taiwan’s National Health Insurance Research Database. The researchers looked at patients, under years old and diagnosed with type 1 diabetes, and compared rates of diabetes between those that had been diagnosed with an enterovirus (EV) and those that had not.

The results of the study showed that children that had been infected with an EV had a 48% increased risk of developing type 1 diabetes than those that had not.

What are enteroviruses?

Enteroviruses are a group of over 100 viruses which include the Coxsackievirus A, Coxsackievirus B, echovirus and polio virus. Polio can sometimes have serious consequences and, for this reason, most people should be, and are, vaccinated against its effects. Other types of enterovirus, such as Coxsackievirus A and B, echovirus and enterovirus D68, are not commonly vaccinated against.

The Centers for Disease Control and Prevention (CDC) states that non-polio enteroviruses are responsible for around 10 to 15 million viral infections each year. The effects of EV infections can vary from person to person with some people displaying only mild symptoms or no symptoms at all whereas others may experience more severe illness and even organ damage. Children and teenagers are at a higher risk of more serious complications as a result of an EV.

How strong is the evidence?

A 48% increase in risk represents a significant correlation, however, correlation can only suggest a cause. Strong correlations are important though as they indicate which areas to focus research on.

Proving viral infection as a cause of autoimmune diseases, such as type 1 diabetes, is a difficult area of research as there is a genetic element to autoimmune diseases which is not easy to replicate.

If research can convincingly show a string causal likelihood of enterviruses, it could allow researchers to develop a vaccine against the entovirus (or enteroviruses) that are thought to cause the disease.