SAT056 New-onset Autoimmune Diabetes After COVID-19 mRNA Vaccine: A Systematic Review

Disclosure: A. Laskova: None. B. Syritsa: None. Background: Vaccination against COVID-19 has become a great tool during the COVID-19 pandemic. Multiple studies have shown that vaccines are safe and effective. However, there have been reports of autoimmune diseases following the vaccination against COVID-19. One of the possible mechanisms is thought to be a reaction to adjuvants in the vaccine (ASIA syndrome). We present a systematic review of the cases of new-onset autoimmune diabetes after the COVID-19 mRNA vaccine. Methods: We included 10 patients from 6 case reports(1-6) and 1 case series(7) published before December 3, 2022. We analyzed demographics, results, and outcomes using descriptive statistics. Results: 60% were males, and 40% were females. The median age was 51.5 years. 70% received the BNT162b2 vaccine, 20% - the mRNA-1273 vaccine, 10% - an unnamed mRNA vaccine. 70% developed symptoms after the second dose of the vaccine. The onset was distributed from 1 week after the first dose to 8 weeks after the third dose. 30% had either personal or family history of autoimmune diseases. Among other 70%, 57% had HLA DRB1 and/or DQB1 alleles (unknown if HLA was tested in other patients). The disease manifested as diabetic ketoacidosis in 50% of the patients. Anti-GAD antibodies were elevated in 70% of the patients. 30% were weaned off insulin shortly after the diagnosis, meanwhile, the rest required insulin by the time of the articles’ writing. We noted that most of the patients who developed autoimmune diabetes after the COVID-19 vaccine had either personal or family history of autoimmune diseases or tested positive for certain pertinent HLA alleles. However, no causal relationship can be established based on the current cohort, and more research needs to be done. References: 1. Jano M, Morioka T, Natsuki Y et al. New-onset type 1 diabetes after COVID-19 mRNA vaccination. Intern Med. 2022;61(8):1197-1200 2. Kobayashi T, Yakou F, Saburi M et al. New-onset atypical fulminant type 1 diabetes after COVID-19 vaccination: A case report. Clin Case Rep. 2022;10(10):e6473 3. Kshetree B, Lee J, Acharya S. COVID-19 Vaccine-induced rapid progression of prediabetes to ketosis-prone diabetes mellitus in an elderly male. Cureus. 2022;14(9): e28830 4. Patrizio A, Ferrari SM, Antonelli A et al. A case of Graves' disease and type 1 diabetes mellitus following SARS-CoV-2 vaccination. J Autoimmun. 2021;125:102738 5. Sasaki H, Itoh A, Watanabe Y et al. Newly developed type 1 diabetes after coronavirus disease 2019 vaccination: A case report. J Diabetes Investig. 2022;13(6):1105-1108 6. Sasaki K, Morioka T, Okada N et al. New-onset fulminant type 1 diabetes after severe acute respiratory syndrome coronavirus 2 vaccination: A case report. J Diabetes Investig. 2022;13(7):1286-1289 7. Aydoğan B, Ünlütürk U, Cesur M. Type 1 diabetes mellitus following SARS-CoV-2 mRNA vaccination. Endocrine. 2022;78:42-46 Presentation: Saturday, June 17, 2023