Pancreatic ACE2 receptor expression, together with increased prevalence of insulin-requiring hyperglycemia in patients with coronavirus disease 2019 (COVID-19), suggested that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pancreatic infection might trigger a β-cell–selective inflammation precipitating autoimmune type 1 diabetes (T1D). We examined T1D incidence in patients with COVID-19 inside a large, global population using a “big data” approach. The incidence in 0–30-year-old patients with confirmed COVID-19 over an ∼15-month period from the beginning of the COVID-19 pandemic was compared with an age-matched population without COVID-19 inside the TriNetX COVID-19 Research Network (>80 million deidentified patient electronic medical records globally). The cohorts were used to generate outcomes of T1D postindex. In those up to 18 years of age, the incidence of insulin-requiring diabetes that could represent T1D in patients with already diagnosed, confirmed COVID-19 was statistically indistinguishable from the control population without COVID-19. In contrast, in those aged 19–30 years, the incidence was statistically greater. These data suggest that the incidence of T1D among patients with COVID-19 <30 years of age, at least up to this time since the beginning of the pandemic, is not greater when compared with an age-, sex-, and BMI-matched population without COVID-19. Nevertheless, we caution that patients with COVID-19 could be asymptomatic of a diabetic/prediabetic state and therefore would not be expected to come to medical attention, remaining undiagnosed. Hence, it is still possible that asymptomatic virus-infected individuals could acquire β-cell autoimmunity, eventually progressing to dysglycemia and clinical T1D at higher rates.

中文翻译：

---

感染 SARS-CoV-2 的年轻人中需要胰岛素的高血糖综合征的发病率：是 1 型糖尿病吗？

胰腺 ACE2 受体表达，以及 2019 年冠状病毒病 (COVID-19) 患者中需要胰岛素的高血糖患病率增加，表明严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 胰腺感染可能引发 β 细胞-选择性炎症诱发自身免疫性 1 型糖尿病 (T1D)。我们使用“大数据”方法检查了全球大量人群中 COVID-19 患者的 T1D 发病率。将 COVID-19 大流行开始后约 15 个月内确诊 COVID-19 的 0-30 岁患者的发病率与 TriNetX COVID-19 中没有 COVID-19 的年龄匹配人群进行了比较研究网络（全球超过 8000 万个未识别身份的患者电子病历）。这些队列用于生成 T1D postindex 的结果。在 18 岁以下的人群中，需要胰岛素的糖尿病的发病率可能代表已确诊 COVID-19 的患者的 T1D，与没有 COVID-19 的对照人群在统计学上无法区分。相比之下，在 19-30 岁的人群中，发病率在统计学上更高。这些数据表明，与年龄、性别和 BMI-没有 COVID-19 的匹配人群。尽管如此，我们警告说，COVID-19 患者可能没有糖尿病/糖尿病前期的症状，因此预计不会就医，仍未确诊。因此，