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Anti-GAD antibody-positive fulminant type 1 diabetes developed following SARS-CoV-2 vaccination

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Abstract

Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been used worldwide since the 2020 coronavirus pandemic. However, several negative side-effects of these vaccines have been reported. Herein, we present a case of a patient with fulminant type 1 diabetes that developed shortly after administration of the SARS-CoV-2 vaccine. A 47-year-old man with no medical history presented with hyperglycemia-related symptoms shortly after receiving the third messenger ribonucleic acid SARS-CoV-2 vaccine. Based on hyperglycemia, diabetic ketoacidosis at onset, relatively low hemoglobin A1c levels, and complete depletion of endogenous insulin secretion, the patient was diagnosed with fulminant type 1 diabetes and insulin therapy was initiated. Through human leukocyte antigen genoty**, the disease-susceptible alleles for type 1 diabetes, DRB1*04:05 and DQB1*04:01, were identified. The patient tested positive for serum anti-glutamic acid decarboxylase antibodies, which are normally negative for fulminant type 1 diabetes, implying that immunomodulation triggered by SARS-CoV-2 vaccination influenced the onset of type 1 diabetes.

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Acknowledgements

This study did not receive any specific grants from external funding sources. We would like to thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Division of Diabetes and Metabolism, Sendai City Hospital, 1-1-1 Asutonagamachi, Taihaku-Ku, Sendai, Miyagi, 982-8502, Japan

    Tomohito Izumi, Hironobu Takahashi & Hironori Takahashi

Authors
  1. Tomohito Izumi
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  2. Hironobu Takahashi
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  3. Hironori Takahashi
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Contributions

All authors contributed to the study conception and design. The first draft of the manuscript was written by TI and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Tomohito Izumi.

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All the authors declare that they have no conflicts of interest.

Ethical approval

This study was conducted in accordance with the 1964 Declaration of Helsinki and its later versions. This article does not contain any studies with animal subjects by any of the authors. The patient’s identity is protected. Informed consent was obtained from the patient included in the study.

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Izumi, T., Takahashi, H. & Takahashi, H. Anti-GAD antibody-positive fulminant type 1 diabetes developed following SARS-CoV-2 vaccination. Diabetol Int 14, 422–426 (2023). https://doi.org/10.1007/s13340-023-00648-8

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