A large-scale study which started 20 years ago to investigate what causes type 1 diabetes in children will end next year, after revealing important new information about how the condition develops.
The TEDDY study has involved almost 8,700 children from Sweden, Finland, Germany and the United States, and some of the findings have led to further specific studies.
The study provides additional evidence that the combination of genetic and environmental factors has an impact on whether someone develops the disease.
Researchers have been closely monitoring how diabetes-related autoantibodies develop in children and the key findings include:
- The presence of diabetes-related autoantibodies indicates that insulin-producing pancreas cells are attacked by the body’s immune system
- Autoantibodies formed against insulin are most common in a child’s first three years of life
- A link between enterovirus infection, the development of diabetes-related autoantibodies and type 1 diabetes
- Giving probiotics to children at increased risk of developing type 1 diabetes can lower the risk of them developing diabetes-related autoantibodies
Co-chair of the study Professor Jeffrey Krischer said: “The study’s success is due to the commitment and sacrifice on the part of the participating children and their families. Most were reassured by the close relationships with study coordinators and the careful monitoring of diabetes risk provided by the study.
“Many of the participating families wanted to help us understand the causes of the disease.”
Åke Lernmark, principal investigator of the TEDDY study in Sweden, said: “Some of us believed that the disease would be diagnosed shortly after the first autoantibody against insulin was formed, but our studies have shown that it can take several years before the child develops the disease.
“Interest in screening for type 1 diabetes within the health care system is increasing in many countries, and our genetic risk scores can be used to identify which children may benefit most from being screened for the disease.”
Some of the findings from the TEDDY study have led to new research projects at Lund University Diabetes Center in Sweden.
One has found that children at greater risk of developing type 1 diabetes due to their genetics, face a greater risk of developing diabetes-related autoantibodies linked to COVID-19 infection.
- New treatment to transform type 1 diabetes care
- Caution urged for off-label glucose-lowering drugs in type 1 diabetes
- Ticks are helping pave the way for new type 1 diabetes treatments
Another study has looked at if the COVID-19 vaccine can stop the development of these autoantibodies.
Findings from the TEDDY study has also furthered understanding of two other autoimmune diseases, coeliac disease and thyroiditis.
Lernmark said: “It is incredible to see that results from the TEDDY study have led to new studies. Even if we stop collecting samples from the children, analysis of the data continues.
“An important question that remains to be answered is what role viral infections play in the development of the disease.
“If we get a firm answer to this question, we can find new ways to stop the disease.”
Read more in Nature Reviews Endocrinology.
