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However, the sample size is too small, and more basic research should be needed in the future

Multiple CVB variants have been shown to induce cell degeneration, pyknosis, reduction of islet identity genes, and decreased insulin content and secretion in primary human islets cultured in vitro or transplanted into diabetic NOD mice ( CVB-induced cell death may be partly caused by virus-induced ER stress since ER stress negatively impacts cell function and viability, leading to T1D onset (184, 188)

The combination of reduced intake and impaired absorption creates a trajectory toward deficiency over months and years of treatment

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