The Environmental Determinants of Diabetes in the Young (TEDDY) Study: 2018 Update

Curr Diab Rep. 2018 Oct 23;18(12):136. doi: 10.1007/s11892-018-1113-2.

Abstract

Purpose of review: The environmental triggers of islet autoimmunity leading to type 1 diabetes (T1D) need to be elucidated to inform primary prevention. The Environmental Determinants of Diabetes in the Young (TEDDY) Study follows from birth 8676 children with T1D risk HLA-DR-DQ genotypes in the USA, Finland, Germany, and Sweden. Most study participants (89%) have no first-degree relative with T1D. The primary outcomes include the appearance of one or more persistent islet autoantibodies (islet autoimmunity, IA) and clinical T1D.

Recent findings: As of February 28, 2018, 769 children had developed IA and 310 have progressed to T1D. Secondary outcomes include celiac disease and autoimmune thyroid disease. While the follow-up continues, TEDDY has already evaluated a number of candidate environmental triggers, including infections, probiotics, micronutrient, and microbiome. TEDDY results suggest that there are multiple pathways leading to the destruction of pancreatic beta-cells. Ongoing measurements of further specific exposures, gene variants, and gene-environment interactions and detailed "omics" studies will provide novel information on the pathogenesis of T1D.

Keywords: Autoimmunity; Children; Type 1 diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Autoimmunity / genetics
  • Biomarkers / metabolism
  • Child
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / genetics
  • Diabetes Mellitus, Type 1 / immunology
  • Environment*
  • Genetic Predisposition to Disease
  • Humans
  • Islets of Langerhans / immunology

Substances

  • Biomarkers