Fohlman, J, Friman, G · Annals of medicine · 1993
This review examines whether viruses—particularly enteroviruses like Coxsackie and ECHO viruses—might trigger type 1 diabetes in children. The authors suggest that a person can catch one of these viruses, and even though the initial infection may go unnoticed, the virus can persist in the body and potentially trigger the immune system to attack the insulin-producing cells in the pancreas. Interestingly, the authors mention that similar persistent viral infections might also play a role in chronic fatigue syndrome.
This study is relevant to ME/CFS research because it documents a plausible mechanism for how persistent enteroviral infection could trigger autoimmune disease and chronic illness in immunocompetent individuals—a model that could apply to ME/CFS pathogenesis. The explicit mention of chronic fatigue syndrome in the context of chronic enteroviral infection suggests early recognition of a potential viral-immune link that warrants further investigation in ME/CFS populations.
This review does not prove that enteroviruses cause type 1 diabetes or ME/CFS—it presents correlational and mechanistic evidence suggesting a possible association. The study does not quantify how frequently chronic enteroviral infection occurs in patients with these conditions, nor does it establish causation from correlation. The connection to ME/CFS is speculative and based on limited data presented in this abstract.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Fohlman, J & Friman, G (1993). Is juvenile diabetes a viral disease?. Annals of medicine. https://pubmed.ncbi.nlm.nih.gov/8292308/
BibTeX
@article{mecfsatlas-fohlman-1993-juvenile-diabetes,
author = {Fohlman, J and Friman, G},
title = {Is juvenile diabetes a viral disease?},
journal = {Annals of medicine},
year = {1993},
note = {PubMed: 8292308},
url = {https://www.mecfsatlas.com/evidence/fohlman-1993-juvenile-diabetes},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/fohlman-1993-juvenile-diabetes
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