Scientific support: Prof. Dr. Carolin Daniel, Dr. Martin Scherm
How exactly type 1 diabetes develops is a mystery. However, factors are known to influence the risk of type 1 diabetes onset. What is certain is that a risk of the disease is to some extent hereditary. However, predisposition alone does not lead to type 1 diabetes.
In addition, environmental influences also seem to play a role. For example, early infections with certain viruses or certain dietary factors may increase the risk of type 1 diabetes onset. Early detection examinations can assess the risk of type 1 diabetes.
Type 1 diabetes is an autoimmune disease and is much rarer than type 2 diabetes. Type 1 diabetes usually starts in childhood or early adulthood. In this disease, the body's immune system attacks certain cells in the pancreas.
Hereditary factors play an important role
What is certain is that type 1 diabetes can be inherited. For example, about 10 out of 100 people will develop type 1 diabetes in their lifetime if a close relative has the disease. Children with fathers who have type 1 diabetes are at a higher risk of developing the autoimmune disease than children with mothers who have type 1 diabetes.
But one thing is certain: The one type 1 gene does not exist. Many different genes are involved in the development of the disease. In the general population, about 3 to 4 out of every 1,000 people develop type 1 diabetes.
Environmental factors also play a role
There is evidence that certain environmental influences promote the development of type 1 diabetes. These include, for example, early infections with certain viruses (coxsackieviruses, rubella viruses, mumps viruses), feeding food containing gluten to infants, a vitamin D deficiency or an unfavorable composition of the intestinal flora. Children born by C-section also have a slightly higher risk of type 1 diabetes.
Autoantibodies show onset of autoimmune reaction
In type 1 diabetes, the body's immune defense attacks cells in the pancreas. The tools the immune system uses in this process are certain autoantibodies (= antibodies that attack cells of the patient's own body). These autoantibodies are often found in the blood of affected individuals years before the disease breaks out. They indicate the start of the autoimmune response of type 1 diabetes.
Hereditary factors play a major role in the development of type 1 diabetes. Nowadays, gene testsare available to determine whether newborns have a predisposition to type 1 diabetes. If certain risk genes are found in the test, the likelihood of developing type 1 diabetes is increased.
In infants and children, the blood can also be tested for the characteristic autoantibodies that are present in type 1 diabetes. These can often be detected long before the onset of the symptomatic disease.
Type 1 diabetes breaks out when the number of cells that have already been destroyed in the pancreas is so high that the body no longer produces insulin in sufficient quantities. Insulin deficiency causes blood sugar levels to rise.
Possible signs of rising blood sugar levels in type 1 diabetes include excessive thirst, frequent urination, fatigue, or weight loss.
In their studies, researchers are getting to the bottom of how type 1 diabetes develops. They are also conducting research on how to reduce the risk of type 1 diabetes onset.
One research topic among others is nutrition at the beginning of life. For example, there is evidence that feeding food containing gluten under 3 months of age increases the risk of type 1 diabetes.
Other dietary ingredients, such as omega-3 fatty acids and vitamin D, on the other hand, could have a beneficial effect. The same applies to the administration of certain probiotics during the 1st month of life. Probiotics are living microorganisms that are believed to have a health-promoting effect. Researchers have been able to show some protective effect of probiotics in children who had an increased genetic risk of type 1 diabetes.
One thing is important: All these indications in studies are not yet really confirmed. Therefore, no independent nutritional experiments should be carried out without consulting a diabetologist or pediatrician.
Achenbach, P.: Risiko für Typ-1-Diabetes auch bei Nachkommen erhöht? In: MMW Fortschritte der Medizin, 2022, 164: 67-69
Alyafei, F. et al.: Clinical and biochemical characteristics of familial type 1 diabetes mellitus (FT1DM) compared to non-familial type 1 DM (NFT1DM). In: Acta Biomed, 2018, 89: 27-31
Beyerlein, A. et al.: Infections in Early Life and Development of Type 1 Diabetes. In: JAMA, 2016, 315: 1899-1901
Bonifacio, E. et al.: Predicting type 1 diabetes using biomarkers. In: Diabetes Care, 2015, 38: 989-996
Deutsche Diabetes Gesellschaft (DDG): S3-Leitlinie Therapie des Typ-1-Diabetes. 2. Auflage. 2018
Frohnert, B. I. et al.: Late-onset islet autoimmunity in childhood: the Diabetes Autoimmunity Study in the Young (DAISY). In: Diabetologia, 2017, 60: 998-1006
Lampousi, A. M. et al.: Dietary factors and risk of islet autoimmunity and type 1 diabetes: a systematic review and meta-analysis. In: EbioMedicine, 2021, 72: 103633
Lorenzen, T. et al.: Predictors of IDDM recurrence risk in offspring of Danish IDDM patients. Danish IDDM Epidemiology and Genetics Group. In: Diabetologia, 1998, 41: 666-673
Norris, J. M. et al.: Timing of Initial Cereal Exposure in Infancy and Risk of Islet Autoimmunity. In: JAMA, 2003, 290: 1713-1720
Rewers, M. et al.: The Environmental Determinants of Diabetes in the Young (TEDDY) Study: 2018 Update. In: Curr Diab Rep, 2018, 18: 136
Winkler, C. et al.: Feature ranking of type 1 diabetes susceptibility genes improves prediction of type 1 diabetes. In: Diabetologia, 2014, 57: 2521-2529
Yeung, W. C. et al.: Enterovirus infection and type 1 diabetes mellitus: systematic review and meta-analysis of observational molecular studies. In: BMJ, 2011, 342: d35
Ziegler, A. G. et al.: Primary prevention of beta-cell autoimmunity and type 1 diabetes – The Global Platform for the Prevention of Autoimmune Diabetes (GPPAD) perspectives. In: Mol Metab, 2016, 5: 255-262
Ziegler, A. G. et al.: Seroconversion to Multiple Islet Autoantibodies and Risk of Progression to Diabetes in Children. In: JAMA, 2013, 309: 2473-2479
Zorena, K. et al.: Environmental Factors and the Risk of Developing Type 1 Diabetes-Old Disease and New Data. In: Biology, 2022, 11: 608
As of: 12.05.2023