The Environmental Determinants of Diabetes in the Young (TEDDY) Study: 2018 Update

Rewers, Marian; Hyöty, Heikki; Lernmark, Åke; Hagopian, William; She, Jin‐Xiong; Schatz, Desmond; Ziegler, Anette‐G.; Toppari, Jorma; Akolkar, Beena; Krischer, Jeffrey P.

doi:10.1007/s11892-018-1113-2

Cited by 90 publications

(101 citation statements)

References 92 publications

(99 reference statements)

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“…The TEDDY Study Group has already assessed a number of environmental candidate triggers, which include probiotics, infections, micronutrient, and microbiome, which could be responsible for recent increase in AD incidence (60). Other possible factors are altering the balance of gut microbiota due to probiotic or antibiotics use (61,62) and epigenetic changes induced by air pollutants (63).…”

Section: Discussionmentioning

confidence: 99%

Increasing Co-occurrence of Additional Autoimmune Disorders at Diabetes Type 1 Onset Among Children and Adolescents Diagnosed in Years 2010–2018—Single-Center Study

et al. 2020

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Objectives: The prevalence of type 1 diabetes mellitus (T1D) in children is growing, but its relation to other autoimmune disorders that coexist since the onset of diabetes is not recognized. The objective of this study was to assess the incidence of T1D and the prevalence of autoimmune illnesses additionally coexisting since the diabetes mellitus onset in children during a period of 9 years' observation. Methods: In this retrospective study, the incidence rate (IR) of the T1D was calculated as the total number of all cases that were newly diagnosed per 100,000 population people between 0 and 18 years of age. The selected age groups (0-4, 5-9, 10-14, and 15-18 years) were examined, respectively. The studied group included 493 children (264 [53.55%] boys) between 0 and 18 years old newly diagnosed with T1D in one of the Polish centers in the years 2010-2018. Other autoimmune illnesses diagnoses were obtained from medical records taken from the first hospital treatment, when T1D was recognized. Results: The annual standardized IR of T1D increased from 19.2/100,000 in year 2010 to 31.7/100,000 in 2018 (1.7-fold over 9 years' observation), with an increase in the incidence rate ratio (IRR) by 4% per year. The highest growth in IR was recorded in 5-to 9-year-olds (from 19.61 in 2010 to 43.45 in 2018). In 61 (12.4%) of the studied group, at least one additional autoimmune disease was diagnosed. The prevalence doubled from 10.4% in the year 2010 to 20.8% in the year 2018. Autoimmune thyroid illnesses were found in 37 children (7.5%); their incidence increased from 6.3% to almost 2-fold, 12.5%, in 2018. In 26 children (5.3%), celiac disease was recognized; the prevalence increased from 4.2 to 9.8% in the study period. The prevalence of additional autoimmune thyroid disease was higher in glutamic acid decarboxylase-positive antibodies (χ 2 = 3.4, p = 0.04) patients, the oldest age group (15-18 years) (χ 2 =7.1, p = 0.06), and in girls (χ 2 =7.1, p = 0.007). Głowińska-Olszewska et al. Autoimmune Comorbidities in T1D Children Conclusions: The standardized IR of T1D in children increased 1.7-fold over the 9-year observation period, and IRR increased 4% per year. Additional autoimmunity represents a significant comorbidity in patients with new-onset T1D. The number of children diagnosed with additional autoimmune diseases that accompany T1D is rapidly growing in all age groups throughout recent years.

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Section: Discussionmentioning

confidence: 99%

Increasing Co-occurrence of Additional Autoimmune Disorders at Diabetes Type 1 Onset Among Children and Adolescents Diagnosed in Years 2010–2018—Single-Center Study

et al. 2020

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“…Data on incidence trends in type 1 diabetes are important given the slower than hoped for progress in the identification of environmental trigger(s) of the disease and the development of prevention strategies. The Environmental Determinants of Diabetes in the Young (TEDDY) study has evaluated multiple candidate environmental triggers, including infections, probiotics, micronutrients and the microbiome [11], since there are multiple pathways that may lead to the destruction of the beta cells resulting in type 1 diabetes [12]. TEDDY brings tremendous opportunity because of the inclusion of three European centres and three centres in the United States, and the capacity (to the extent feasible based on statistical power) to consider the differential impact of various potential environmental triggers across centres.…”

Section: Potential Influence Of Genetic and Environmental Risk Factormentioning

confidence: 99%

What do we know about the trends in incidence of childhood-onset type 1 diabetes?

Lawrence

Mayer‐Davis

2018

Diabetologia

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“…According to the EuroDIAB (European Diabetes) study, the incidence of T1D among children (boys and girls) of 0–4 years increased by 3.7%, 5–9 years increased by 3.4% in boys and 3.7% in girls and 10–14 years age groups increased by 3.3% in boys and 2.6% in girls per annum, respectively, over the last 25 years [2]. In addition, as per the combined data, the lifetime risk for occurrence of T1D has exceeded more than 1% in European and North American people [3]. The latest Environmental Determinants of Diabetes in the Young (TEDDY) study has reported that more than half of T1D cases are diagnosed after 20 years of age [3].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, as per the combined data, the lifetime risk for occurrence of T1D has exceeded more than 1% in European and North American people [3]. The latest Environmental Determinants of Diabetes in the Young (TEDDY) study has reported that more than half of T1D cases are diagnosed after 20 years of age [3].…”

Section: Introductionmentioning

confidence: 99%

Probiotics and Prebiotics for the Amelioration of Type 1 Diabetes: Present and Future Perspectives

et al. 2019

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Type 1-diabetes (T1D) is an autoimmune disease characterized by immune-mediated destruction of pancreatic beta (β)-cells. Genetic and environmental interactions play an important role in immune system malfunction by priming an aggressive adaptive immune response against β-cells. The microbes inhabiting the human intestine closely interact with the enteric mucosal immune system. Gut microbiota colonization and immune system maturation occur in parallel during early years of life; hence, perturbations in the gut microbiota can impair the functions of immune cells and vice-versa. Abnormal gut microbiota perturbations (dysbiosis) are often detected in T1D subjects, particularly those diagnosed as multiple-autoantibody-positive as a result of an aggressive and adverse immunoresponse. The pathogenesis of T1D involves activation of self-reactive T-cells, resulting in the destruction of β-cells by CD8+ T-lymphocytes. It is also becoming clear that gut microbes interact closely with T-cells. The amelioration of gut dysbiosis using specific probiotics and prebiotics has been found to be associated with decline in the autoimmune response (with diminished inflammation) and gut integrity (through increased expression of tight-junction proteins in the intestinal epithelium). This review discusses the potential interactions between gut microbiota and immune mechanisms that are involved in the progression of T1D and contemplates the potential effects and prospects of gut microbiota modulators, including probiotic and prebiotic interventions, in the amelioration of T1D pathology, in both human and animal models.

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The Environmental Determinants of Diabetes in the Young (TEDDY) Study: 2018 Update

Cited by 90 publications

References 92 publications

Increasing Co-occurrence of Additional Autoimmune Disorders at Diabetes Type 1 Onset Among Children and Adolescents Diagnosed in Years 2010–2018—Single-Center Study

Increasing Co-occurrence of Additional Autoimmune Disorders at Diabetes Type 1 Onset Among Children and Adolescents Diagnosed in Years 2010–2018—Single-Center Study

What do we know about the trends in incidence of childhood-onset type 1 diabetes?

Probiotics and Prebiotics for the Amelioration of Type 1 Diabetes: Present and Future Perspectives

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