Diabetes and viruses in Australia and the Asia-pacific region

Abstract

Clinical studies from Australia and the Asia-Pacific region support an association between type 1 diabetes and several viruses, including rubella, RV and EV. Meta-analysis has demonstrated a significant association between EV infection and type 1 diabetes globally, as well as in this region. Detailed studies of EV outbreaks have identified genotypes distinct to the region. In particular, an outbreak of EV71 in 1997-1999 was temporally associated with the most common virus isolated from an Australian incident cohort of children with type 1 diabetes. In this study, EV infection was more common in young people without high-risk HLA genotypes, suggesting that there may be a subgroup of virus-induced type 1 diabetes. Fulminant diabetes is a unique form of diabetes found predominantly in Asian patients with rapid onset, ketosis-prone diabetes. Concurrent viral infections, in particular EV, are also associated with this form of diabetes. Further evaluation of the clinical characteristics of young people and adults with virus-induced diabetes in the region, in parallel with examination of molecular characteristics of isolates, may provide innovative insights into the pathogenesis of type 1 diabetes and fulminant diabetes.