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Type 1 diabetes registry for children and adults set to launch

13th March 2024

The UK’s first type 1 diabetes registry for children and adults at risk of the condition is to be launched by the University of Oxford after receiving a grant from the charity Diabetes UK.

The grant of £610,480 will support the creation of a database and website to form the foundation of the registry. Individuals who test positive for diabetes autoantibodies in clinical care will be added to the registry, along with those identified in screening studies.

The team will also work with clinical and research sites, and approach people who would be interested in joining.

The aims of the registry include providing guidance for doctors on how best to care for and support people who are at risk of type 1 diabetes (T1D) and identify whether being at risk causes people to attend their GP or A&E more regularly. This will allow healthcare teams to catch the onset of T1D as early as possible.

The registry will also collect data on how T1D develops and aid understanding of why people progress from being antibody positive and at risk of T1D to needing insulin.

Dr Rachel Besser, a paediatric diabetes consultant at Oxford University Hospitals NHS Foundation Trust and researcher at the University of Oxford’s Centre for Human Genetics, who is leading the project, said: ‘This registry is a first for the UK and brings together children and adults who are at risk of T1D.

‘It is an important step towards a better understanding of the care and support people at high risk of type 1 require, allowing us to offer them a “softer landing” into life with the condition.’

Indeed, the registry can also be used to inform people about treatments and research into T1D prevention, particularly immunotherapy that they could get involved in to help prevent or delay T1D onset.

People on the registry will also be easier to reach with resources to support people after diagnosis, and support people with the mental health burden of living with T1D.

Dr Loredana Marcovecchio, academic consultant in paediatric endocrinology and diabetes at the University of Cambridge and co-lead for the project, added: ‘We’re hoping that it will be easier to tell people about opportunities to take part in research to develop new treatments that might prevent or delay the onset of T1D.’

The Diabetes Trials Unit at Oxford University will host the registry, and Cambridge University will co-lead with the support of researchers from Birmingham, Bristol, Cardiff, Dundee, Edinburgh, Exeter, Imperial College and the British Heart Foundation.

Recruitment to the type 1 diabetes registry is expected to start later in 2024.

Around 400,000 people live with T1D in the UK, including over 29,000 children and young people, and it is becoming more prevalent.

In fact, the incidence of type 1 diabetes in children and adolescents significantly increased during the Covid-19 pandemic compared to pre-pandemic levels, according to a meta-analysis published in 2023. Causal mechanisms for this change are still unclear.

Previous research also suggested that the risk of T1D was significantly elevated in children and adolescents more than 30 days after an infection with Covid-19.

Risk registries are increasingly being developed to reveal more about how genetic variation affects diagnoses of conditions such as Lynch syndrome, which exposes people to greater risk of bowel and other cancers.

Diabetes risk remains elevated three months after COVID-19 infection

26th July 2022

The risk of diabetes after infection with COVID-19 remains high for at least three months before declining to background levels

The diabetes risk from infection with COVID-19 stays elevated for three months after the acute infection before declining according to the findings of a study by researchers based at King’s College, London, UK.

Emerging evidence suggests that infection with COVID-19 is associated with many adverse sequelae as shown by increased incident use of several therapeutic agents such as pain medications, antidepressants, anxiolytics and oral hypoglycaemic agents, highlighting an increased diabetes risk. Moreover, other work has suggested that COVID-19 is a risk factor for acute myocardial infarction and ischaemic stroke in the first 2 weeks following an acute infection.

While many of those infected with COVID-19 make a full recover, it is also recognised that approximately 10%-20% of people experience a variety of mid and long-term effects which are collectively known as post COVID-19 condition or long COVID. Whether the cardiometabolic risks of COVID-19 remain high over the longer term is uncertain.

A further complication when trying to assess this level of increased risk, is that the restrictions imposed by the various COVID-19 lockdowns, may have led to changes with an individual’s diet and physical activity which may also have impacted on cardiometabolic risk.

Therefore, when trying to better understand whether infection with COVID-19 increases diabetes risk, it is necessary to compare the incidence of these diseases among those who were infected with matched, non-infected controls.

For the present study, the UK researchers conducted a population-based, matched cohort study using the CPRD Aurum, a large and comprehensive medical records database. They focused on both diabetes and cardiovascular disease (CVD) and identified a COVID-19 cohort and which was matched (based on age, gender and practice) to individuals with no recorded diagnosis of infection with the virus, although those with pre-existing diabetes or cardiovascular disease were excluded.

For the purposes of analysis, the researchers set the index date as when the first code for COVID-19 infection was recorded in the notes and examined the incidence of diabetes and CVD over four periods of time: 4 weeks prior to the index date; 4 weeks after this date; 5 to 12 weeks later and finally, from weeks 13 to 52 after the acute infection.

The study outcomes were the first recorded diagnoses of diabetes and CVD. The results were adjusted for several covariates known to be associated with diabetes and CVD e.g., smoking status, body mass index and blood pressure.

Diabetes risk and COVID-19

A total of 431,193 individuals with a median age of 35 years (44%) males were matched to an equal number of control patients.

In the first four weeks after infection with COVID-19, the diabetes risk increased by 1.8 times (incidence rate ratio, IRR = 1.81, 95% CI 1.51 – 2.19, p < 0.001). However, this risk remained elevated between 5 and 12 weeks after the index date (IRR = 1.27, 95% CI 1.11 – 1.46, p < 0.001).

However, between weeks 13 and 52, the rate, while still slightly higher, became non-significant (IRR = 1.07, 95% CI 0.99 – 1.16, p = 0.07). There were also significant elevations for CVD up to 12 weeks which again became non-significant after 13 weeks.

The authors concluded that an important finding of their study was how the diabetes risk remained higher for at least 3 months after an acute COVID-19 infection. They suggested that patients recovering from the virus should consider measures to reduce their diabetes risk through diet, weight management and physical activity levels.

Rezel-Potss E et al. Cardiometabolic outcomes up to 12 months after COVID-19 infection. A matched cohort study in the UK PLoS Med 2022