Updates on the Environmental Triggers of Type 1 Diabetes From ADA 2020
Updates on the Environmental Triggers of Type 1 Diabetes (ADA 2020) By, Kathryn Gentile, B.S., CPT
The onset of type 1 diabetes (T1D) usually consists of a genetic predisposition and an “environmental trigger” (such as a viral infection).
For me, I know autoimmune disorder runs in my family and I can also predict that my environmental trigger was stress-I was diagnosed with T1D when my mom was undergoing chemotherapy. Many of my friends with T1D were diagnosed after an illness. Research is coming a long way in predicting a person’s chances of developing diabetes. Updates were provided at ADA on possible environmental triggers.
A multi-center international research effort called TEDDY (The Environmental Determinants of Diabetes in the Young) has been investigating potential environmental triggers that may induce the onset of type 1 diabetes in children.
TEDDY also works to find ways to prevent the onset of T1D and other autoimmune diseases. As described in their recent press release: TEDDY is aiming to discover viruses and nutritional factors that interact with genes to “trigger” destruction of the beta cells(no-they don’t think eating too much sugar as a kid gives you T1D). The study evaluates infants “at-risk” for developing T1D and follows them for 15 years. Additionally, TEDDY has studied biomarkers that can predict faster or slower progression to diabetes after the autoimmune destruction has begun.
New Information About The Environmental Triggers of Type 1 Diabetes
It appears that beta cell destruction often begins very early in life
There may be two distinct subtypes of type 1 diabetes characterized by genetics, immune system, and various metabolomic markers.
The value of HbA1c as a predictive factor for developing T1D may differ between youth and adults.
Presence of enterovirus B in stool samples is predictive of islet autoimmunity development in children.
The gut microbiome composition tends to be different in children who develop islet autoantibodies as compared to those who do not. The use of probiotics may help to lower this risk.
Use of antibiotics was not shown to be related to autoimmunity.
Vitamin D, C, and polyunsaturated fats may carry preventative benefits against autoimmunity but needs to be validated in further studies.
Updates were also provided on environmental triggers of celiac disease, a common autoimmune disease seen in combination with T1D. Recent research identified a link between the consumption of gluten early in childhood to an increased risk for developing celiac disease for those with a genetic predisposition.
The work TEDDY is doing is very important because they are seeking to understand the relationships between genetic predispositions to autoimmune disease. This gives explanation to how they may be triggered which is critical to the development of effective preventative strategies in the future. I think I’m comfortable with saying the only thing better than a cure for T1D is preventing it all together. Of course, we would want the benefit to outweigh the risk.
Kathryn Gentile is a clinical exercise physiology student from Lancaster, PA who is pursuing her Master’s degree and also working towards becoming a Certified Diabetes Educator. Additionally, she is an ACSM-CEP(clinical exercise physiologist), Certified Personal Trainer, and Certified Sports Nutritionist.