Ice Hockey World Championships 2011 will be membered from amazing goal by Mikael Granlund against Russia at the semifinals.
Type 1 diabetes (T1D) is the most common metabolic-endocrine disorder in children in western countries. Finland has the highest incidence of T1D in the world. Moreover, the incidence has increased more five-fold in Finland over the last sixty years; from 12/100000 in 1953, to 64.2/100000 in 2005.
T1D is caused by loss of insulin-secreting capacity of the β cells and, finally, by selective death of these cells in the islets of Langerhans in the pancreas. T1D is an autoimmune disease characterized by a relatively long symptom-free period that precedes the flair-up of clinical signs of the disease. In almost all children, progression to clinical T1D is associated with the presence of β cell specific autoantibodies. Clinical T1D occurs when 80-90% of the β cells have been destroyed. At this point T1D patient is dependent on a daily insulin substitution for the rest of his/her life and there is a high risk of developing acute and long-term complications.
An individual’s genetic makeup is known to influence the likelihood for developing diabetes. It is nevertheless evident, that regardless of the multiple loci associated to T1D, the impact of genetics on T1D aetiology is limited. In fact a family history of T1D only serves to increase the risk of T1D, and even in monozygotic twins, the proband-wise concordance for T1D is as low as fifty per cent. It is also argued, that the increase in magnitude in T1D incidence over a relatively short space of time cannot be attributed solely to enhanced genetic disease susceptibility. The pathogenesis of human T1D is under genetic as well as environmental control, and it is plausible that environmental factors play a notable role in increased disease prevalence.
Nowadays it is widely accepted that dietary and microbial factors may be partly responsible for the increase in T1D incidence. These two factors are closely related, since the diet has a direct effect on microbial species prevalence in the intestine. In many diseases, including T1D, the reasons behind microbial-dependent disorders seem to come down to an induction of inflammation in the gut epithelium and/ or increased permeability of the intestinal wall.
List of suspected dietary triggers of T1D is atleast partly quite surprising:
- vegetables, root vegetables and berries
- cow milk proteins
- wheat and barley proteins
The role of viral infections as a trigger for T1D in humans has been studied extensively. Amongst the viruses that have been suggested to confer an increased T1D risk are enteroviruses (in particular coxsackie virus B), rubella virus, mumps virus, rota virus, retrovirus, cytomegalovirus and Epstein-Barr virus. The correlation between viral infections and T1D incidence has, however, not been eminent in all studies and it has also been argued that atleast enterovirus infections are not likely to be the cause of the increase in T1D incidence, since these infections are much less common in Finland compared with Russia, despite the significantly higher T1D incidence in Finland.
Fundamentally, whatever the environmental triggers will be, they are likely to be something we are exposed to early on in childhood. This is because the greatest increase in T1D incidence has been observed in children diagnosed under 5 years of age, and the earliest signs of autoimmunity become evident under one year of age.
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