The rising incidence of type 1 diabetes is a global health crisis. While its causes remain unclear, genetic or environmental influences are suspected as possible influences.
Genetic studies utilizing affected sib pair (ASP) families and case-control series as a basis to identify specific regions associated with type 1 diabetes, using fine mapping approaches that assess thousands of variants within these regions.
Epigenetics
Epigenetics was coined by Conrad Waddington in 1942(a), as the study of factors “above the genes” which influence gene expression and development of phenotype. Epi-phenotypes may include chemical tags like DNA methylation or histone post-translational modifications that alter gene expression either by suppressing it or encouraging its activity.
Epigenetic mechanisms are heritable alterations of gene transcription that do not alter the sequence of base pairs in DNA, yet are necessary for normal cell growth, differentiation and genome stability.
These processes serve as additional regulators of immune responses and may play a pivotal role in autoimmunity development. Recent studies indicate that children at genetic risk for type 1 diabetes possess epigenetic changes to their immune cells long before any presence of antibodies against diabetes appears in their blood (see figure 1).
Changes to epigenetic profiles appear to be driven by lifestyle and environment factors that interact with genetic susceptibility for developing autoimmune diseases. For instance, children living in homes where family members with type 1 diabetes have an increased risk of type 1 themselves if their diet contains too much sugar and not enough fiber – factors which directly impact epigenetic profiles.
Environmental Influences
Researchers are seeking environmental explanations for the recent 3% annual rise in Type 1 diabetes incidence, such as air pollution, diet and childhood obesity; breastfeeding length; introduction of cow’s milk into children; or infections such as Coxsackie virus, enteroviruses, cytomegalovirus or rubella.
But much remains unexplained: something in the environment must have initiated the destruction of beta cells by autoimmunity in people already predisposed genetically, although exactly why remains unclear; perhaps triggering something within our immune systems that “turns on” when something triggers it?
The switch initiates a response that attacks insulin producing beta cells of the pancreas. Insulin helps manage blood sugar levels within our bodies; when beta cells are destroyed, glucose cannot get into our bodies to survive and this causes symptoms such as:
Lifestyle Changes
As scientists research new treatments and prevent complications of Type 1 diabetes, they’re also trying to understand its cause. One theory suggests environmental triggers – such as viruses or diet changes – as a possible factor; but their exact nature remains unknown.
Though Type 1 diabetes cannot be avoided entirely, you can protect yourself by adopting healthy habits. These include exercising regularly and eating a balanced diet with limited saturated fat and added sugars. Furthermore, seek supportive relationships rather than those who may sabotage your progress or confidence.
Recent research indicates that a person’s microbiome composition may impact their risk for T1D. Researchers noted that babies born via cesarean section tend to have more limited microbiomes compared with those delivered vaginally.
Researchers are exploring another factor – socioeconomic status. Studies have revealed that certain groups, such as Hispanics and blacks, are more likely to develop Type 1 diabetes than others due to long-standing policies and systems of oppression that keep these communities from attaining health equity; poorer people often lack access to nutritious foods and health services which leads to an increase in complications related to the condition as well as hospital stays.
