The autoimmune destruction of insulin producing cells often begins in the first 2 years of life, according to an update from the long running The Environmental Determinants of Diabetes in the Young (TEDDY) study.

Type 1 diabetes (T1D) affects 1 of every 300 children in the United States, according to a TEDDY study presentation at the American Diabetes Association’s (ADA) 80th Virtual Scientific Sessions. Children with T1D pose certain types of genes, however, not all of the children with those genes develop T1D.

The TEDDY study aims at identifying environmental triggers that cause the immune destruction of beta cells. The study also examines celiac disease, an autoimmune condition. Celiac disease and T1D share many genetic factors, according to a press release.  

The study, which is funded by the ADA, has collected data since 2004. It follows infants identified as ‘at-risk’ for the development of T1D and follows them for 15 years in order to look for the appearance of various beta-cell autoantibodies and diabetes. Additionally, the study tracks biomarkers that can predict how the speed of diabetes progression after autoimmune destruction has begun.

The study has also found that the persistent presence of enterovirus B species in stool can predict the development of islet autoimmunity compared with control groups. This is especially true of the earlier subtype, which is characterized by the presence of autoantibodies of insulin. Additionally, there are subtle differences in the composition and function of gut microbiome in children who develop islet autoantibodies. Probiotics may decrease the risk if used early enough.

Additionally, the TEDDY study has found that a diet rich in vitamin D, vitamin C, or polyunsaturated fatty acids may also be beneficial, but this has yet to be confirmed in randomized clinical trials.

“There appear to be 2 subtypes of T1D that differ by genetic factors and immune phenotypes. Metabolomic biomarkers may offer clues to the subtypes and whether a child develops T1D. Interestingly, HbA1c has very different predictive characteristics for progression to clinical diabetes in children with islet autoantibodies, compared to adults with risk factors for type 1 diabetes,” said Marian Rewers, MD, PhD, TEDDY co-chair, professor of pediatrics and medicine, executive director of the Barbara Davis Center for Diabetes at the University of Colorado School of Medicine, in a press release.

Results from the study are ongoing and will be used in new clinical trials to help prevent autoimmune diseases.


REFERENCE

Latest TEDDY Report Outlines Research on Type 1 Diabetes and Celiac Disease [news release]. Chicago, IL; June 15, 2020: American Diabetes Association [email]. Accessed June 15m 2020.