My 10 year old son was diagnosed with type 1 diabetes about four months ago following a viral infection. Why is there no information on how a viral infection can attack the pancreas and cause type 1 diabetes?

Except for German measles in pregnancy and some enterovirus infections there is little evidence that viral infections actually cause type 1 diabetes. What often happens though is that an intercurrent viral infection may exacerbate an already existing autoimmune process to the point that insulin is required.

DOB
Additional comments from Dr. David Schwartz:

As for your son’s diagnosis of type1 diabetes following a viral infection, it should be noted that this is clearly the exception and not the rule. More than about 95% of type 1 diabetes is associated with various types of autoimmune antibodies “attacking” the pancreas. This is type 1A (autoimmune) diabetes. There is also type 1B, which is very similar but generally antibody negative. Pancreatic trauma and infection and other injury as well as various medications (generally chemotherapies and some very potent anti-inflammation/rejection medicines) can also lead to type 1 diabetes. The viruses that have been linked most often to diabetes are a class called enterovirus and the most common is called Coxsackie B virus (this can also cause hand-foot-mouth disease although the more often culprit is Coxsackie A).

How does the virus lead to decreased insulin production? Is there a common path between Coxsackie inflammation and the development of autoimmunity? Before the antibodies against the pancreas were uncovered, the dogma was that ‘diabetes is probably caused by a virus.’ This is generally not the case now. Medical texts indeed provide information about other causes of diabetes besides autoimmunity.

DS