What does SARS-CoV-2 tell us about the aetiology of environmental triggers for diabetes in children and young people?

Type 1 diabetes mellitus (T1DM) is caused by the autoimmune destruction of β cells in the pancreatic islets and accounts for over 90% of childhood diabetes. A significant increase in new-onset childhood T1DM has been reported in the COVID-19 pandemic,1-4 but the link with SARS-CoV-2 remains an enigma. This quandary is not unique to SARS-CoV-2. Despite over 100 years of investigation, the search for contributing environmental triggers, and the extent to which they play a role in the aetiology and progression of new-onset diabetes remains a challenge.