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Biomed Res Int. 2015;2015:321656. doi: 10.1155/2015/321656. Epub 2015 Mar 25.

Environmental trigger(s) of type 1 diabetes: why so difficult to identify?

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Department of Pediatric Research, Division for Women and Children, Oslo University Hospital, Rikshospitalet, 0027 Oslo, Norway.


Type 1 diabetes (T1D) is one of the most common chronic diseases with childhood onset, and the disease has increased two- to fivefold over the past half century by as yet unknown means. T1D occurs when the body's immune system turns against itself so that, in a very specific and targeted way, it destroys the pancreatic β-cells. T1D results from poorly defined interactions between susceptibility genes and environmental determinants. In contrast to the rapid progress in finding T1D genes, identification and confirmation of environmental determinants remain a formidable challenge. This review article will focus on factors which have to be evaluated and decision to take before starting a new prospective cohort study. Considering all the large ongoing prospective studies, new and more conclusive data than that obtained so far should instead come from international collaboration on the ongoing cohort studies.

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