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Why is type 1 diabetes increasing?

Clearly lifestyle factors raise the incidence of type 2 diabetes, but what are the reasons for the rise in the prevalence of type 1 diabetes?
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© Deakin University
We have seen that around the world diabetes is increasing. In Australia, around 280 new cases of diabetes are diagnosed each day, and most of these are type 2 diabetes.
Several studies and reports show an increase in the incidence of type 1 diabetes around the world.
What are the reasons for the rise in type 1 diabetes?
A paper by Francesco Maria Ergo (2013) reviews some recent hypotheses about why type 1 diabetes is increasing.
In people with a genetic susceptibility to type 1 diabetes, certain environmental ‘triggers’ may start a process whereby the immune system begins to kill off the Beta cells that make insulin (autoimmunity). Some of the hypotheses for environmental triggers include:
  • Hygiene hypothesis: exposure to a variety of infectious agents in early childhood appears to be protective against type 1 diabetes by promoting a healthy immune system.
  • Viral hypothesis: some viruses (including enterovirus, rubella, mumps and cytomegalovirus) may start or speed up the autoimmune process in type 1 diabetes.
  • Vitamin D deficiency: type 1 diabetes is more prevalent in countries with less sunshine, (further from the equator) and low vitamin D levels are associated with a higher risk of type 1 diabetes.
  • Breastfeeding versus cow’s milk hypothesis: proposed mechanisms are that (1) breastmilk may contain protective factors and (2) proteins present in cow’s milk formula may trigger type 1 diabetes.
  • Gut microbiota: we carry a huge variety and number of bacteria in our intestines, and these bacteria make various chemicals that affect our health. Some bacteria promote healthy functioning of our body, and others increase inflammation and may affect the development of the immune system.
Currently, there is the strongest support for the hygiene hypothesis.

Your task

Read the paper by Egro (2013). The below questions should guide your reading:
  • What are the reasons for the rise of type 1 diabetes discussed in the article?
  • Are the same reasons at play for the increase in type 2 diabetes?
  • What can we do as a society to reduce the incidence of diabetes?
Post your response to these questions in the comments. Try to use evidence and scientific reasoning, rather than opinion.
Note: Those with less time and/or experience with reading journal articles may wish to read just the abstract and the conclusion as a starting point.
© Deakin University
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Demystifying Diabetes

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