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Endocrine
Published in: Endocrine 1/2022

09-07-2022 | Vaccination | Original Article

Type 1 diabetes mellitus following SARS-CoV-2 mRNA vaccination

Authors: Berna İmge Aydoğan, Uğur Ünlütürk, Mustafa Cesur

Published in: Endocrine | Issue 1/2022

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Abstract

Purpose

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccines have been reported to trigger immune side effects. Type 1 diabetes as a manifestation of autoimmune/inflammatory syndrome induced by adjuvants has been reported in a limited number of cases after vaccinations. A few type 1 diabetes cases after SARS-CoV-2 vaccination have been reported. This study aims to report type 1 diabetes cases associated with the mRNA-based SARS-CoV-2 vaccination.

Methods

We report four cases of type 1 diabetes mellitus after mRNA-based SARS-CoV-2 vaccine, BNT162b2 (Pfizer–BioNTech). In the medical history, one subject had autoimmune thyroid disease. All patients had autoantibodies against glutamate decarboxylase.

Results

In the presented case series, type 1 diabetes developed a few weeks after BNT162b2 vaccination. After developing type 1 diabetes, the insulin dose requirements of all patients decreased rapidly, and the need for insulin therapy in three patients disappeared during follow-up. Acute deterioration of glucose regulation in a patient followed by BNT162b2 administration may be due to vaccine-induced autoimmune diabetes.

Conclusion

Vaccination with BNT162b2 may trigger type 1 diabetes.
Literature
1.
T. Pilishvili, R. Gierke, K.E. Fleming-Dutra, J.L. Farrar, N.M. Mohr, D.A. Talan, A. Krishnadasan, K.K. Harland, H.A. Smithline, P.C. Hou et al. Effectiveness of mRNA Covid-19 vaccine among U.S. Health Care Personnel. N. Engl. J. Med 385(25), e90 (2021)CrossRef
2.
F.P. Polack, S.J. Thomas, N. Kitchin, J. Absalon, A. Gurtman, S. Lockhart, J.L. Perez, G. Perez Marc, E.D. Moreira, C. Zerbini et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N. Engl. J. Med. 383(27), 2603–2615 (2020)CrossRef
3.
O. Vera-Lastra, A. Ordinola Navarro, M.P. Cruz Domiguez, G. Medina, T.I. Sanchez Valadez, L.J. Jara, Two cases of Graves’ disease following SARS-CoV-2 vaccination: an autoimmune/inflammatory syndrome induced by adjuvants. Thyroid 31(9), 1436–1439 (2021)CrossRef
4.
A. Pujol, L.A. Gomez, C. Gallegos, J. Nicolau, P. Sanchis, M. Gonzalez-Freire, A.A. Lopez-Gonzalez, K. Dotres, L. Masmiquel, Thyroid as a target of adjuvant autoimmunity/inflammatory syndrome due to mRNA-based SARS-CoV2 vaccination: from Graves’ disease to silent thyroiditis. J. Endocrinol. Investig. 45(4), 875–882 (2021).CrossRef
5.
M.Sozen, O.Topaloglu, B. Cetinarslan, A.Selek, Z. Canturk, E.Gezer, D.Koksalan, T.Bayraktaroglu, COVID-19 mRNA vaccine may trigger subacute thyroiditis. Hum. Vaccin Immunother 17(12), 5120–5125 (2021).CrossRef
6.
A. Patrizio, S.M. Ferrari, A. Antonelli, P. Fallahi, A case of Graves’ disease and type 1 diabetes mellitus following SARS-CoV-2 vaccination. J. Autoimmun. 125, 102738 (2021)CrossRef
7.
L.D. Kaulen, S. Doubrovinskaia, C. Mooshage, B. Jordan, J. Purrucker, C. Haubner, C. Seliger, H.M. Lorenz, S. Nagel, B. Wildemann et al. Neurological autoimmune diseases following vaccinations against SARS-CoV-2: a case series. Eur. J. Neurol. 29(2), 555–563 (2022)CrossRef
8.
S.R.V. Gadi, P.A.R. Brunker, H. Al-Samkari, D.B. Sykes, R.R. Saff, J. Lo, P. Bendapudi, D.E. Leaf, R.K. Leaf, Severe autoimmune hemolytic anemia following receipt of SARS-CoV-2 mRNA vaccine. Transfusion 61(11), 3267–3271 (2021)CrossRef
9.
Y. Shoenfeld, N. Agmon-Levin, ‘ASIA’ - autoimmune/inflammatory syndrome induced by adjuvants. J. Autoimmun. 36(1), 4–8 (2011)CrossRef
10.
N.L. Bragazzi, A. Hejly, A. Watad, M. Adawi, H. Amital, Y. Shoenfeld, ASIA syndrome and endocrine autoimmune disorders. Best Pract. Res. Clin. Endocrinol. Metab. 34(1), 101412 (2020)CrossRef
11.
A. Watad, N.L. Bragazzi, D. McGonagle, M. Adawi, C. Bridgewood, G. Damiani, J. Alijotas-Reig, E. Esteve-Valverde, M. Quaresma, H. Amital et al. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) demonstrates distinct autoimmune and autoinflammatory disease associations according to the adjuvant subtype: Insights from an analysis of 500 cases. Clin. Immunol. 203, 1–8 (2019)CrossRef
12.
H. Sasaki, A. Itoh, Y. Watanabe, Y. Nakajima, Y. Saisho, J. Irie, S. Meguro, H. Itoh, Newly developed type 1 diabetes after coronavirus disease 2019 vaccination: a case report. J. Diabetes Investig. 13(6), 1105–1108 (2022).CrossRef
13.
K. Sasaki, T. Morioka, N. Okada, Y. Natsuki, Y. Kakutani, A. Ochi, Y. Yamazaki, T. Shoji, T. Ohmura, M. Emoto, New-onset fulminant type 1 diabetes following SARS-CoV-2 vaccination: A case report. J. Diabetes Investig. 13(7), 1286–1289 (2022).CrossRef
14.
M. Yano, T. Morioka, Y. Natsuki, K. Sasaki, Y. Kakutani, A. Ochi, Y. Yamazaki, T. Shoji, M. Emoto, A case of new-onset type 1 diabetes after covid-19 mRNA vaccination. Intern. Med. 61(8), 1197–1200 (2022).CrossRef
15.
F. Bril, Autoimmune hepatitis developing after coronavirus disease 2019 (COVID-19) vaccine: One or even several swallows do not make a summer. J. Hepatol. 75(5), 1256–1257 (2021)CrossRef
16.
B.G. Iremli, S.N. Sendur, U. Unluturk, Three cases of subacute thyroiditis following SARS-CoV-2 vaccine: postvaccination ASIA syndrome. J. Clin. Endocrinol. Metab. 106(9), 2600–2605 (2021)CrossRef
17.
S. Shekhar, R. Wurth, C.D.C. Kamilaris, G. Eisenhofer, F.J. Barrera, M. Hajdenberg, J. Tonleu, J.E. Hall, E.L. Schiffrin, F. Porter et al. Endocrine conditions and COVID-19. Horm. Metab. Res. 52(7), 471–484 (2020)CrossRef
18.
J. Lan, J. Ge, J. Yu, S. Shan, H. Zhou, S. Fan, Q. Zhang, X. Shi, Q. Wang, L. Zhang et al. Structure of the SARS-CoV-2 spike receptor-binding domain bound to the ACE2 receptor. Nature. 581(7807), 215–220 (2020)CrossRef
19.
D. Fignani, G. Licata, N. Brusco, L. Nigi, G.E. Grieco, L. Marselli, L. Overbergh, C. Gysemans, M.L. Colli, P. Marchetti et al. SARS-CoV-2 receptor angiotensin I-converting enzyme type 2 (ACE2) is expressed in human pancreatic beta-cells and in the human pancreas microvasculature. Front Endocrinol. 11, 596898 (2020)CrossRef
20.
J.K. Yang, S.S. Lin, X.J. Ji, L.M. Guo, Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetol. 47(3), 193–199 (2010)CrossRef
21.
J. Li, X. Wang, J. Chen, X. Zuo, H. Zhang, A. Deng, COVID-19 infection may cause ketosis and ketoacidosis. Diabetes Obes. Metab. 22(10), 1935–1941 (2020)CrossRef
22.
F. Wang, H. Wang, J. Fan, Y. Zhang, H. Wang, Q. Zhao, Pancreatic injury patterns in patients with coronavirus disease 19 pneumonia. Gastroenterology 159(1), 367–370 (2020)CrossRef
23.
R. Unsworth, S. Wallace, N.S. Oliver, S. Yeung, A. Kshirsagar, H. Naidu, R.M.W. Kwong, P. Kumar, K.M. Logan, New-onset type 1 diabetes in children during COVID-19: multicenter regional findings in the U.K. Diabetes Care 43(11), e170–e171 (2020)CrossRef
24.
S.K. Boddu, G. Aurangabadkar, M.S. Kuchay, New onset diabetes, type 1 diabetes and COVID-19. Diabetes Metab. Syndr. 14(6), 2211–2217 (2020)CrossRef
25.
I. Kusmartseva, W. Wu, F. Syed, V. Van Der Heide, M. Jorgensen, P. Joseph, X. Tang, E. Candelario-Jalil, C. Yang, H. Nick et al. Expression of SARS-CoV-2 entry factors in the pancreas of normal organ donors and individuals with COVID-19. Cell Metab. 32(6), 1041–1051 (2020). e1046CrossRef
26.
K.C. Coate, J. Cha, S. Shrestha, W. Wang, L.M. Goncalves, J. Almaca, M.E. Kapp, M. Fasolino, A. Morgan, C. Dai et al. SARS-CoV-2 cell entry factors ACE2 and TMPRSS2 are expressed in the microvasculature and ducts of human pancreas but are not enriched in beta cells. Cell Metab. 32(6), 1028–1040 (2020). e1024CrossRef
27.
A. Watad, N.L. Bragazzi, H. Amital, Y. Shoenfeld, Hyperstimulation of adaptive immunity as the common pathway for silicone breast implants, autoimmunity, and lymphoma of the breast. Isr. Med. Assoc. J. 21(8), 517–519 (2019)PubMed
28.
S. Colafrancesco, C. Perricone, L. Tomljenovic, Y. Shoenfeld, Human papilloma virus vaccine and primary ovarian failure: another facet of the autoimmune/inflammatory syndrome induced by adjuvants. Am. J. Reprod. Immunol. 70(4), 309–316 (2013)CrossRef
29.
C.M. Girgis, R.R. Russo, K. Benson, Subacute thyroiditis following the H1N1 vaccine. J. Endocrinol. Invest 33(7), 506 (2010)CrossRef
30.
A. Vojdani, E. Vojdani, D. Kharrazian, Reaction of human monoclonal antibodies to SARS-CoV-2 Proteins with tissue antigens: implications for autoimmune diseases. Front Immunol. 11, 617089 (2020)CrossRef
31.
Y.H. Chung, V. Beiss, S.N. Fiering, N.F. Steinmetz, COVID-19 vaccine frontrunners and their nanotechnology design. ACS Nano 14(10), 12522–12537 (2020)CrossRef
32.
S. Xu, K. Yang, R. Li, L.Zhang, mRNA vaccine era-mechanisms, drug platform and clinical prospection. Int. J. Mol. Sci. 21(18), 6582 (2020).CrossRef
33.
T. Zhong, R. Tang, S. Gong, J. Li, X. Li, Z. Zhou, The remission phase in type 1 diabetes: Changing epidemiology, definitions, and emerging immuno-metabolic mechanisms. Diabetes Metab. Res. Rev. 36(2), e3207 (2020)CrossRef
34.
J. Ludvigsson, L.G. Heding, beta-Cell function in children with diabetes. Diabetes 27(Suppl 1), 230–234 (1978)CrossRef
35.
M. Fonolleda, M. Murillo, F. Vazquez, J. Bel, M. Vives-Pi, Remission phase in paediatric type 1 diabetes: new understanding and emerging biomarkers. Horm. Res. Paediatr. 88(5), 307–315 (2017)CrossRef
36.
A.L. Fitas, C. Martins, L.M. Borrego, L. Lopes, A. Jorns, S. Lenzen, C. Limbert, Immune cell and cytokine patterns in children with type 1 diabetes mellitus undergoing a remission phase: a longitudinal study. Pediatr. Diabetes 19(5), 963–971 (2018)CrossRef
37.
M.S. Kuchay, P.K. Reddy, S. Gagneja, A. Mathew, S.K. Mishra, Short term follow-up of patients presenting with acute onset diabetes and diabetic ketoacidosis during an episode of COVID-19. Diabetes Metab. Syndr. 14(6), 2039–2041 (2020)CrossRef
Metadata
Title
Type 1 diabetes mellitus following SARS-CoV-2 mRNA vaccination
Authors
Berna İmge Aydoğan
Uğur Ünlütürk
Mustafa Cesur
Publication date
09-07-2022
Publisher
Springer US
Published in
Endocrine / Issue 1/2022
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-022-03130-8

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