AzTrials
AzTrials

Covid19NCT04623697

Covid-19 Infection and New Onset Type 1 Diabetes

An observational study of Covid19 and type1diabetes, run by Esbjerg Hospital - University Hospital of Southern Denmark at 1 site in Denmark.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

Although recognized as an autoimmune disease the etiology of type 1 diabetes remains unknown. Virus infections has been suggested as a possible agent triggering the autoimmune reaction finally resulting in beta-cell destruction and fate of insulin secretion. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Covid19, type1diabetes
How many people
600 participants
Where
1 siteDenmark
Study dates
1 Nov 2020to 31 Dec 2024
How long will I take part?
2 Years
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: All newly diagnosed people with type 1 diabetes

Who may be able to join

  • T1D patients diagnosed according to standard practice (including Hba1c, C-peptide, presence of GAD (or islet-cell) antibodies).
  • Patient is attending a hospital unit in Denmark or Portugal, due to T1D.
  • Age 18 years or above.

Who cannot join

  • Severe psychiatric disorder or other conditions deemed to impair the patient's informed consent and participation in the study.

Trial locations and contacts

1 site in 1 country.

Claus B Juhl, MD PhD contact

+4560867172

Claus.Bogh.Juhl@rsyd.dk

Morten Bjerregaard-Andersen, MD PhD contact

+4528112956

Morten.Bjerregaard-Andersen2@rsyd.dk

Denmark1 site, 1 recruiting
  • Hospital of South West Jutland

    Esbjerg, 6700

    Claus B Juhl, MD, PhD, +4560867172, claus.bogh.juhl@rsyd.dk

    Morten Bjerregaard-Andersen, MSc, PhD, +4528112956, Morten.Bjerregaard-Andersen2@rsyd.dk

    Recruiting

Other trials in Denmark

About this study

Official title: Covid-19 and Type 1 Diabetes - a Multicenter Study

Although recognized as an autoimmune disease the etiology of type 1 diabetes remains unknown. Virus infections has been suggested as a possible agent triggering the autoimmune reaction finally resulting in beta-cell destruction and fate of insulin secretion. SARS Cov-2 virus enters the infected cells by binding to the ACE-2 receptor, which is abundant in many tissues including the pancreas. Accordingly, SARS Covid-19 infection may trigger the development of type 1 diabetes either by an activation of the immune system or directly via beta-cell infection and destruction.

Our aim is to study the impact of the Covid-19 epidemic on the development of type 1 diabetes. This will be done in two ways: a clinical study and an epidemiological follow up. During the next two years, adult patients with newly diagnosed type 1 diabetes will be asked to participate. Type 1 diabetes will be diagnosed by usual means and a mixed meal tolerance test will be performed at time of diagnosis and after one year to evaluate beta-cell function. People with type 1 diabetes and serologically documented previous SARS Covid-19 will be compared with people with no previous infection regarding beta-cell function and fate of insulin secretion. In addition, we will estimate the number of new diagnosed type 1 diabetes patients compared to previous years.

Read the detailed description

Background

Although recognized as an autoimmune disease, the etiology of type 1 diabetes mellitus (T1D) remains undetermined. One dominant hypothesis is that a recent virus infection elicits or enhances an autoimmune reaction, resulting in CD4+ and CD8+ T-cells recognizing pancreatic antigens and subsequently targeting the beta-cells of the pancreas. This results in a gradual but irreversible loss of beta-cell function.

Various enterovirus species have been suspected as causative factors of T1D. However, many different viruses may carry the potential to induce T1D via one of the above-mentioned mechanisms, including respiratory infections.

Most people are presently immunologically inert to SARS-Cov-2, but a large proportion of the world's population is expected to be infected over the next few years, with the global focus having now shifted to slowing the spread (1). The pandemic of COVID-19 therefore provides an opportunity to study a possible correlation between a novel type of virus infection and the development of T1D.

Aim

Our overall aim is to study the impact of Covid-19 on the incidence and the phenotype (beta-cell function at time of diagnosis and at follow up) of newly diagnosed adult patients with T1D in a multicenter study, with enrolments to occur in both Denmark and Portugal.

Method

The following study populations are established over a two-year period, beginning in October 2020:

  1. Study population 1: Newly diagnosed adult patients with T1D according to usual practice, stratified for the presence of SARS-Cov-2-antibodies (+/-), in both Denmark and Portugal.
  2. Study population 2: A control population of the same age (+/- 3 years) and sex from each participant country, potentially from the national blood banks. This will provide the SARS-Cov-2 status of the background population. Each newly diagnosed T1D patient is matched with five control persons.

Study 1: Clinical study: Study 1:

Inclusion criteria:

  • T1D patients diagnosed according to standard practice (including Hba1c, C-peptide, presence of GAD (or islet-cell) antibodies).
  • Patient is attending a hospital unit in Denmark or Portugal, due to T1D.
  • Age 18 years or above.

Exclusion criteria:

  • Severe psychiatric disorder or other conditions deemed to impair the patient's informed consent and participation in the study.

In each country, all subjects from study population 1 will undergo the following assessments at diagnosis of T1D:

  1. SARS-Cov-2 antibody measurement.
  2. GAD-antibodies (and if necessary islet cell antibodies (IA-2)).
  3. HbA1c, fasting blood glucose and fasting C-peptide.
  4. Mixed-meal tolerance test (MMTT).
  5. Follow-up one year after the diagnosis with HbA1c, fasting blood glucose, fasting C-peptide and MMTT.

Study 2: Epidemiological study 1: In each country, the incidence of SARS-Covid-2 antibodies in study group 1 is compared to the matched control group (Study population 2).

Study 3: Epidemiological study 2: Independently of the above mentioned study, the incidence of newly diagnosed T1D patients in each participant country will be determined by registry data from January 1st 2020 on a monthly basis and compared with newly diagnosed T1D patients from the two previous years (2018 and 2019).

Outcomes

The study will have the following outcomes

Study 1 (clinical study):

Primary outcome: C-peptide AUC of the MMTT at baseline and one year follow-up, for adult T1D patients having SARS-Cov-2 positive vs. negative antibody status.

Secondary outcomes: Fasting glucose, C-peptide, Hba1c at baseline and one year follow-up, for adult T1D patients having SARS-Cov-2 positive vs. negative antibody status.

Study 2 (epidemiological study 1):

Outcome: Proportion of T1D patients having SARS-Cov-2 antibodies, compared to matched controls from the background population, potentially from the national blood banks (1:5 match on age, gender and if possible country region).

Study 3 (epidemiological study 2):

Outcome: Annual and monthly T1D incidence (cases/100.000) during 2020-2022, compared to 2018 and 2019 in Denmark and Portugal.

Keywords
Covid19, Type 1 diabetes
Medical subject headings
COVID-19, Diabetes Mellitus, Type 1

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Stimulated insulin secretion

    C-peptide AUC of the MMTT at baseline and one year follow-up

    Measured: One years

Secondary outcomes (2)
  1. HbA1c

    HbA1c measure at one year

    Measured: One years

  2. Fasting blood glucose

    Fasting blood glucose

    Measured: One years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Nov 2020
  2. Study start1 Nov 2020
  3. Primary completion31 Dec 2024 (estimated)
  4. Study completion31 Dec 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
600 participants (estimated)
Target duration
2 Years
IDs, dates and publications
ClinicalTrials.gov ID
NCT04623697
Sponsor's protocol ID
S-20200119
Status last verified
Oct 2023
First submitted
9 Nov 2020
Last updated
24 Oct 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Filippi CM, von Herrath MG. Viral trigger for type 1 diabetes: pros and cons. Diabetes. 2008 Nov;57(11):2863-71. doi: 10.2337/db07-1023. No abstract available.

    PubMed 18971433
  • Coleman TJ, Gamble DR, Taylor KW. Diabetes in mice after Coxsackie B 4 virus infection. Br Med J. 1973 Jul 7;3(5870):25-7. doi: 10.1136/bmj.3.5870.25.

    PubMed 4577716
  • Christoffersson G, Flodstrom-Tullberg M. Mouse Models of Virus-Induced Type 1 Diabetes. Methods Mol Biol. 2020;2128:93-105. doi: 10.1007/978-1-0716-0385-7_7.

    PubMed 32180188
  • Stone VM, Hankaniemi MM, Svedin E, Sioofy-Khojine A, Oikarinen S, Hyoty H, Laitinen OH, Hytonen VP, Flodstrom-Tullberg M. A Coxsackievirus B vaccine protects against virus-induced diabetes in an experimental mouse model of type 1 diabetes. Diabetologia. 2018 Feb;61(2):476-481. doi: 10.1007/s00125-017-4492-z. Epub 2017 Nov 18.

    PubMed 29151123
  • Hyoty H, Leon F, Knip M. Developing a vaccine for type 1 diabetes by targeting coxsackievirus B. Expert Rev Vaccines. 2018 Dec;17(12):1071-1083. doi: 10.1080/14760584.2018.1548281. Epub 2018 Nov 29.

    PubMed 30449209
  • Moltchanova EV, Schreier N, Lammi N, Karvonen M. Seasonal variation of diagnosis of Type 1 diabetes mellitus in children worldwide. Diabet Med. 2009 Jul;26(7):673-8. doi: 10.1111/j.1464-5491.2009.02743.x.

    PubMed 19573115
  • Karaoglan M, Eksi F. The Coincidence of Newly Diagnosed Type 1 Diabetes Mellitus with IgM Antibody Positivity to Enteroviruses and Respiratory Tract Viruses. J Diabetes Res. 2018 Aug 16;2018:8475341. doi: 10.1155/2018/8475341. eCollection 2018.

    PubMed 30186878
  • Patterson CC, Gyurus E, Rosenbauer J, Cinek O, Neu A, Schober E, Parslow RC, Joner G, Svensson J, Castell C, Bingley PJ, Schoenle E, Jarosz-Chobot P, Urbonaite B, Rothe U, Krzisnik C, Ionescu-Tirgoviste C, Weets I, Kocova M, Stipancic G, Samardzic M, de Beaufort CE, Green A, Soltesz G, Dahlquist GG. Seasonal variation in month of diagnosis in children with type 1 diabetes registered in 23 European centers during 1989-2008: little short-term influence of sunshine hours or average temperature. Pediatr Diabetes. 2015 Dec;16(8):573-80. doi: 10.1111/pedi.12227. Epub 2014 Oct 15.

    PubMed 25316271
  • Bindom SM, Lazartigues E. The sweeter side of ACE2: physiological evidence for a role in diabetes. Mol Cell Endocrinol. 2009 Apr 29;302(2):193-202. doi: 10.1016/j.mce.2008.09.020. Epub 2008 Oct 1.

    PubMed 18948167
  • Yang JK, Lin SS, Ji XJ, Guo LM. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetol. 2010 Sep;47(3):193-9. doi: 10.1007/s00592-009-0109-4. Epub 2009 Mar 31.

    PubMed 19333547
  • Bjerregaard-Andersen M, Hostrup PE, Kolnes KJ, Bangshaab M, Andries AR, Silva JD, Carvalho E, Hansen TK, Vestergaard P, Pociot F, Hojlund K, Juhl CB. COVID-19 infection prior to the onset of type 1 diabetes does not impair beta-cell function: a two-year nationwide follow-up study. BMC Endocr Disord. 2026 Jun 15. doi: 10.1186/s12902-026-02358-z. Online ahead of print.

    PubMed 42298525

Questions about this trial

What is this clinical trial studying?

An observational study of Covid19 and type1diabetes, run by Esbjerg Hospital - University Hospital of Southern Denmark at 1 site in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 24 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Claus B Juhl, MD PhD (+4560867172, Claus.Bogh.Juhl@rsyd.dk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Stimulated insulin secretion (time frame: One years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04623697, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Oct 2023.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in