New Clues into the Triggers of Type 1 Diabetes

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Gestational characteristics and metabolic changes are associated with autoimmunity

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JDRF-supported study findings presented during the 51st annual European Association for the Study of Diabetes (EASD) meeting suggest researchers are narrowing in on factors that may cause type 1 diabetes (T1D). The findings could be an important step toward a key JDRF goal: preventing development of T1D in at-risk individuals.

During the early stages of T1D, beta cell autoimmunity develops, which destroys insulin-producing cells and is manifest by the detection of islet autoantibodies. Researchers believe that various environmental and genetic factors trigger the development of T1D. In three separate studies presented during the EASD conference in Stockholm, Sweden, September 14-18, 2015, JDRF-supported scientists showed certain gestational characteristics and metabolic changes occurred in people who develop T1D.

In one study, Åke Lernmark, M.D., Ph.D., of Lund University (Malmö, Sweden) and his team examined the development of autoimmunity in children with high genetic risk of developing T1D. The data were generated from The Environmental Determinants of Diabetes in the Young (TEDDY) project, an ongoing longitudinal study that is following more than 7,000 at-risk children from infancy to 15 years of age to tease out the causes of T1D. Dr. Lernmark aimed to find out whether certain prenatal and maternal factors affected the children’s risk of developing autoantibodies. Among other findings, he noted that TEDDY participants whose birthweight was in the lowest 25 percent were less likely to develop islet autoantibodies and beta cell autoimmunity. Further research is needed to determine whether birthweight has a long-term effect on the development of T1D.

In a second study examining TEDDY data, researcher Carina Törn, Ph.D., also of Lund University, reported that children whose mothers had islet autoantibodies but not T1D were less likely to have autoantibodies than children whose mothers had both autoantibodies and T1D. The results suggest that gestational exposure may affect the development of autoimmunity in children at risk for T1D.

In the final study, Tijana Marinkovic, Ph.D., and her colleagues at the Steno Diabetes Center, Gentofte, Denmark, used data from the DIABIMMUNE study—a project that is endeavoring to determine if a link exists between hygiene and development of T1D—to track the metabolic profiles of study subjects. The participants were followed from infancy to 3 years of age and grouped according to the number of different islet autoantibodies they had. Dr. Marinkovic’s team found that children with two or more islet autoantibodies, which is associated with high risk of progressing to symptomatic T1D, had significantly higher or lower expression of specific groups of metabolites including triglycerides and lysophosphatidylcholines compared with those with one or no autoantibodies. More research is needed to find out what is driving these metabolic changes and whether they play a direct role in the development of T1D, but the differences point to a potential clue towards unraveling what triggers risk and the start of T1D.

Why It Matters

Research on factors that may cause T1D advances progress toward a key JDRF goal: preventing development of T1D in at-risk individuals.

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By Monica Harrington