Zeroing In On Type 1

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Overview Identifying the likely environmental triggers behind the rapid rise of childhood-onset type 1 diabetes. Background Type 1 diabetes has been described as an invisible disease. Those untouched by type 1 diabetes rarely see or understand the 24-hour a day balancing act that goes on behind the scenes. A person living with type 1 diabetes must constantly monitor their intake of carbohydrates, insulin, exercise, stress and a multitude of other factors that affect blood glucose levels. It’s a constant burden that, so far, cannot be removed and the consequences of having blood glucose levels that are too low or too high can be dire. Even more worryingly, over the past 20 years the rate of childhood-onset type 1 diabetes in Australia and around the world has doubled. Experts Recently, some good news has emerged. A team led by the University of Adelaide’s Robinson Research Institute and the Women’s and Children’s Hospital is conducting a landmark Australia-wide study that it hopes will reveal the disease’s pre- and post-birth environmental triggers, and inform its prevention and cure. Status We believe the modern environment that the child is exposed to in early life holds the key to understanding the increase in type 1 diabetes. Factors such as nutrition, weight gain, chronic inflammation, viral infections and the bacteria colonization of our bodies (the microbiome) may drive or protect against the development of type 1 diabetes. Importantly, children are exposed to these factors in-utero, which is where the origins of type 1 diabetes may lie. This seems likely as the first detectable sign of diabetes developing is commonly in the first year of life, long before the disease presents clinically. Focus The research aims to identify the early life exposures that lead to type 1 diabetes and the genes that are involved. Future The potential of the ENDIA study to accelerate the global understanding of type 1 diabetes has been recognized internationally and the study was recently awarded an $8m grant from US-based charity The Helmsley Charitable Trust in partnership with JDRF Australia’s Type 1 Diabetes Clinical Research Network. In addition to the recent funding boost, the ENDIA study is being conducted through a Centre for Research Excellence based at the University of Adelaide with $2.5 million in funds from the National Health and Medical Research Council and JDRF Australia. Other contributing institutions are the Walter and Eliza Hall Institute, Royal Melbourne Hospital, University of New South Wales, University of Sydney, University of Western Australia and University of Queensland.