Pandemic's Mark on T1D Autoimmunity
Type 1 diabetes in children involves islet and endocrine autoantibodies. COVID-19 lockdowns and weight gain may alter these patterns. A study published in the BMJ Open Diabetes Research and Care checks those links in a large group. It looks at beta-cell, thyroid, celiac, and adrenal markers over time.
Large Registry Tracks Key Changes
Data came from Diabetes Prospective Follow-up Registry for 11,973 kids aged 0.5 to under 18 years with new T1D from 2015 to 2023. The cohort was split evenly with 6136 (51%) diagnosed pre-COVID, 5837 (49%) during/after. The researchers measured islet antigen 2 (IA2), zinc transporter 8 (ZnT8), glutamic acid decarboxylase (GAD), insulin), thyroid, transglutaminase (TGA), and adrenals. 
Autoantibody Shifts by Era and Weight
Beta-cell autoantibodies hit 94.3% overall, thyroid 7.7%, TGA 8.3%, adrenal 5.6%. Post-COVID, IA2 rose to 63.3% from 60.5% (p=0.002), GAD to 65.9% from 64.0% (p=0.04). ZnT8 fell to 68.0% from 71.9% (p=0.002); insulin held steady (p=0.06). BMI tied positively to IA2, ZnT8, insulin but not GAD. Thyroid and TGA showed no COVID link; adrenal dropped in pandemic.
Implications for Pediatric Diabetes Care
Pandemic and higher BMI reshape T1D autoimmunity profiles. IA2 surge hints at quicker disease onset. No broad endocrine autoimmunity spike occurred. Track weight in new cases.