Type 1 Diabetes Triggers

By Sandra Gordon

Type 1 diabetes, which accounts for nearly all of the diabetes in kids under age 10, is on the rise among children and adolescents almost everywhere in the world. The disease occurs when the body's immune system attacks healthy, insulin-producing beta cells in the pancreas, preventing the pancreas from producing the insulin it needs. Anyone with type 1 diabetes must have an underlying genetic susceptibility to autoimmunity (about 40 percent of the population). But DNA alone can't account for the type 1 diabetes upturn. "We know that genes don't change that quickly," says Lori Laffel, M.D., M.P.H., chief of Pediatrics at Joslin Diabetes Center in Boston, which is affiliated with Harvard Medical School. "There has to be an environmental influence present globally to have led to this increase."

There's no definitive trigger to date that has been identified to cause type 1 diabetes. Currently, however, a landmark 15-year study called the Environmental Determinants of Diabetes in Youth (TEDDY) is underway at six clinical centers in the U.S. and Europe, tracking 8,000 newborns at high risk genetically for type 1 diabetes. Scientists will likely know much more about what triggers the process that ultimately leads to type 1 diabetes in children in a decade or so, when the results of this study are in. Meanwhile, more potentially definitive studies are ongoing. Here's a round-up of some of the possible environmental triggers under investigation.