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Updates on the Environmental Triggers of Type 1 Diabetes (ADA 2020


By Maria Muccioli Ph.D.

Maria Muccioli is a staff writer at Diabetes Daily. She is also a full-time biology professor and proud mom of two young children. Maria was diagnosed with type 1 diabetes as an undergraduate biochemistry student, which inspired her to pursue graduate work in the immunology field. She earned a Ph.D. in Molecular and Cellular Biology from Ohio University and was also a postdoctoral researcher at the Ohio State University and a fellow at the Brigham and Women’s Hospital and Harvard Medical School. Maria is passionate about harnessing her formal research and teaching experiences to deliver up-to-date and evidence-based information to the diabetes community. She firmly believes in empowering all people with diabetes to learn as much as they can about how to manage their condition and enjoys connecting with the community through her writing and on social media. She is most passionate about new advances in research and technology, optimizing diet to improve glycemic control, and helping women with diabetes gain the most relevant knowledge to achieve healthy pregnancies.

June 15th, 2020

The onset of type 1 diabetes (T1D) usually entails a genetic predisposition to developing the condition, as well as an “environmental trigger” (such as a viral infection, or another exposures). As we previously reported, 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 since 2004.

As described in the most recent press release:

“TEDDY is aiming to discover viruses and nutritional factors that interact with genes to “trigger” immune destruction of the beta cells, marked by the appearance of islet autoantibodies. The study enrolls infants identified as “at-risk” for developing T1D and follows them for 15 years to look for the appearance of various beta-cell autoantibodies and diabetes. TEDDY has also studied biomarkers that can predict faster or slower progression to diabetes after the autoimmune destruction has begun.”

Now, new data on environmental connections between type 1 diabetes as well as celiac disease were just presented today at the American Diabetes Association (ADA) 80th Scientific Sessions. Dr. Marian Rewers, MD, PhD from the Barbara Davis Center for Diabetes at the University of Colorado School of Medicine, along with other presenters, provided the new research updates.

Key Takeaways

Here are the major highlights:

•It appears that beta cell destruction often begins very early in life; as early as in the first two years of life.

•There may be two distinct subtypes of type 1 diabetes that are characterized by differences in their genetics, immune system, and various metabolomic markers.

•The value of HbA1c as a predictive factor for developing type 1 diabetes may differ between youth and adults who develop the condition.

•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 mitigate this risk.

•Use of antibiotics WAS NOT shown to be related to autoimmunity.

•Vitamin D, vitamin C, and polyunsaturated fats may carry preventative benefits against autoimmunity, although this needs to be validated in further studies.

Another interesting update was concerning the environmental determinants of celiac disease. There is some overlap in the genetic factors that are associated with the development of type 1 diabetes and celiac disease. Interestingly, recent research has identified a link between the consumption of gluten early in childhood and an increased risk for developing celiac disease among those with a genetic predisposition.

Dr. Rewers had this to say in summary:

“While T1D and celiac disease share a lot of genetic characteristics, there are intriguing differences in the ways these diseases develop and progress,” added Dr. Rewers. “TEDDY is contributing exciting clues for design of future trials to prevent both T1D and celiac disease.”


The multidisciplinary international TEDDY research effort continues to uncover important pieces of the complex puzzle to explain exactly how and why certain individuals develop type 1 diabetes and other autoimmune conditions. Understanding the relationships between genetic predispositions to autoimmune disease and how they may be triggered is critical to the development of effective preventative strategies in the future.

Stay tuned for more research updates from ADA 2020!

Read more about A1c, American Diabetes Association (ADA), autoimmune disease, beta cells, celiac disease, children with diabetes, diabetes diagnosis, environment, Intensive management, microbiome.

Last Updated: June 12th, 2020

Filed Under: Children with Diabetes, News, Type 1 Diabetes



1 Reply

Thank you for this article.

TEDDY (The Environmental Determinants of Diabetes in the Young).

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