The changing epidemiology of type 1 diabetes: why is it going through the roof?

Abstract

The incidence of type 1 diabetes is increasing and this may double the burden of disease in our youngest by 2020. The recent increase in incidence is mostly happening in the very young and those with moderate genetic susceptibility. Many environmental factors have been implicated, but no major determinants have been clearly identified, and the mechanisms of involvement remain elusive. This review summarizes current research efforts directed at understanding the possible reasons for this increase, including the role of viruses, gut microbiota, early life feeding patterns, perinatal factors and childhood growth patterns. It also provides a road map for future research directions.

Immunological Functions of Oxidized Human Immunoglobulin G in Type 1 Diabetes Mellitus: Its Potential Role in Diabetic Smokers as a Biomarker of Elevated Oxidative Stress

“…Despite the power of modern molecular approaches and persisting investigative efforts, diabetes mellitus remains an enigmatic disorder or the agent (or agents) triggering this disease remains to be identified [22]. Oxidative stress plays a central role in the onset of diabetes as well as in diabetes associated complications [1].…”

“…We and others have reported the presence of elevated levels of oxidized protein products (advanced oxidation protein products) such as oxidized plasma protein in patients with various diseases [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Furthermore, ROS modified IgG is highly immunogenic in rabbits, and the antigenic specificity of affinity purified anti-ROS-IgG antibodies and anti-IgG antibodies suggest that induced antibodies are immunogen-specific.…”

Urinary Phthalates and Increased Insulin Resistance in Adolescents

“…19 In the context of increasing diabetes in youth globally, 20,21 and absent changes of genetic predisposition over the same time period, concern about environmental exposures as a possible contributor is warranted.…”

Estudio temporal de diabetes mellitus tipo 1 en Chile: asociación con factores ambientales durante el período 2000-2007

“…Se conoce con bastante certeza el papel de ciertos genes involucrados en el componente autoinmune de la enfermedad, sin embargo, esta información no ha sido suficiente para explicar el progresivo aumento que se ha observado en todo el mundo en los últimos años 11 . En este sentido, el componente ambiental pasa a ser de particular importancia ya que existen múltiples factores ambientales que se han asociado a la DM1.…”