Studies show new insight into development of type 1 diabetes

EASD Annual Meeting

There are a series of environmental and external factors modifying the disease process of type 1 diabetes, according to Mikael Knip, MD, PhD.

Knip, a professor of pediatrics at the Hospital for Children and Adolescents, University of Helsinki, in Finland, discussed various discoveries that may shed light on the pathogenesis of type 1 diabetes at the 46th Annual European Association for the Study of Diabetes (EASD) Annual Meeting.

Previous research has uncovered genes that contribute to the susceptibility of type 1 diabetes. More recent research has uncovered about 40 more genes that also contribute to the susceptibility the disease. However, only about 10% of genetically susceptible individuals actually develop the disease, according to Knip.

“This implies that additional factors are needed to trigger and drive the disease process,” Knip said in a press release. “Gene-gene and gene-environmental interactions, as well as interactions between two or more environmental factors, are also most likely operative in the various phases of the process, making the identification of the role of isolated determinants challenging.”

The “trigger-booster” hypothesis suggests that the development of type 1 diabetes is triggered by an environmental factor, such as an infectious agent, according to Knip. This is then possibly driven by a dietary antigen. Data from previous studies suggest that certain viruses in the enterovirus group may trigger the disease process. Bovine insulin in cow’s milk products may be a possible driving antigen.

Data presented at the EASD meeting suggest that root vegetables introduced in infancy is a risk factor for the development of diabetes-associated autoantibodies. Researchers in Finland conducted the study, which included 6,069 infants with susceptibility to type 1 diabetes. They found that early introduction of root vegetables, by age 4 months, was related to an increase of diabetes-associated autoantibodies, especially islet cells.

In another study presented at the EASD meeting, researchers found that there are metabolic changes that precede the appearance of autoantibodies in children to develop type 1 diabetes later. According to Knip, gut bacterial microflora is decreased in the autoantibody-positive children, which may also be related to the increased rate of type 1 diabetes.

“Additional work including the application of modern approaches such as metabolomics and epigenomics is needed to discern the pathogenesis of the disease process leading to the manifestation of type 1 diabetes,” Knip said.

For more information:

Pflueger. #261.
BVirtanen SM. #140. Both presented at: 46^th European Association for the Study of Diabetes Annual Meeting; Sept 20-24, 2010; Stockholm, Sweden.

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