T1D can develop at any age but occurs most frequently in children and adolescents, as such when T1D affects younger people it may be referred to as “Juvenile Diabetes”. With insulin the sole therapy, T1D is often also referred to as Insulin Dependent Diabetes. Approximately 5- 10% of patients with diabetes are T1D. T1D is an autoimmune disease which occurs when the body does not produce enough insulin, the aetiology (cause) of T1D is not fully understood but it is believed to be as result of damage to the β-cells of the pancreas caused by immune cells called T-cells. Risk factors associated with T1D include both genetic and environmental factors.
Genetic factors: More than 50 T1D genetic risk loci have been identified by genome-wide association studies and meta-analyses. The main genetic mutations predisposing to T1DM are on the following genes, Insulin-VNTR, CTLA-4, PTPN22, AIRE, FoxP3, STAT3, IFIH1, HIP14 and ERBB3.
Environmental factors: The autoimmune response resulting in T1D can be triggered by viruses such as Rubella, Coxsackie B4, and enteroviruses. There is growing evidence associating the early introduction of cow’s milk in the infant’s diet with an increased risk for T1D, supporting ideas that infant’s exposure to insulin contained in the milk is triggering the autoimmune response. Early integration of cereals, nitrate exposure from water intake, inadequate intake of omega-3 fatty acids and vitamin D deficiency have also been implicated.