The Challenges of Identifying Environmental Determinants of Type 1 Diabetes: In Search of the Holy Grail

Sonia Butalia,1– 4 Gilaad G Kaplan,1– 3 Bushra Khokhar,2 Sydney Haubrich,5 Doreen M Rabi1– 4,6 1Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; 2Department of Community Health Sciences, Cumming School of Medicine, Uni...

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Autores principales:	Butalia S, Kaplan GG, Khokhar B, Haubrich S, Rabi DM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	type 1 diabetes risk factors epidemiology Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/612f8f84a0e04b65b3d16ab6d4838853
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spelling	oai:doaj.org-article:612f8f84a0e04b65b3d16ab6d48388532021-12-02T16:10:54ZThe Challenges of Identifying Environmental Determinants of Type 1 Diabetes: In Search of the Holy Grail1178-7007https://doaj.org/article/612f8f84a0e04b65b3d16ab6d48388532020-12-01T00:00:00Zhttps://www.dovepress.com/the-challenges-of-identifying-environmental-determinants-of-type-1-dia-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Sonia Butalia,1– 4 Gilaad G Kaplan,1– 3 Bushra Khokhar,2 Sydney Haubrich,5 Doreen M Rabi1– 4,6 1Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; 2Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; 3O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; 4Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; 5Ward of the 21st Century, University of Calgary, Calgary, Alberta, Canada; 6Department of Cardiac Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, CanadaCorrespondence: Sonia ButaliaDivision of Endocrinology and Metabolism, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road SW, Calgary, Alberta T2T 5C7, CanadaTel +1 403-955-8327Fax +1 403-955-8249Email sbutalia@ucalgary.caAbstract: Type 1 diabetes is the result of autoimmune-mediated destruction and inflammation of the insulin-producing β-cells of the pancreas. The excess morbidity and mortality from its complications coupled with its increasing incidence emphasize the importance to better understand the etiology of this condition. It has a strong genetic component, but a genetic predisposition is not the sole contributor to disease development as only 30% to 50% of identical twins both develop the disease. In addition, there are multiple lines of evidence to support that environmental factors contribute to the pathogenesis of type 1 diabetes. Environmental risk factors that have been proposed include infections, dietary factors, air pollution, vaccines, location of residence, childhood obesity, family environment and stress. Researchers have conducted many observational studies to identify and characterize these potential environmental factors, but findings have been inconsistent or inconclusive. Many studies have had inherent methodological issues in recruitment, participation, defining cases and exposures, and/or data analysis which may limit the interpretability of findings. Identifying and addressing these limitations may allow for greatly needed advances in our understanding of type 1 diabetes. As such, the purpose of this article is to review and discuss the limitations of observational studies that aim to determine environmental risk factors for type 1 diabetes and propose recommendations to overcome them.Keywords: type 1 diabetes, risk factors, epidemiologyButalia SKaplan GGKhokhar BHaubrich SRabi DMDove Medical Pressarticletype 1 diabetesrisk factorsepidemiologySpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 13, Pp 4885-4895 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	type 1 diabetes risk factors epidemiology Specialties of internal medicine RC581-951
spellingShingle	type 1 diabetes risk factors epidemiology Specialties of internal medicine RC581-951 Butalia S Kaplan GG Khokhar B Haubrich S Rabi DM The Challenges of Identifying Environmental Determinants of Type 1 Diabetes: In Search of the Holy Grail
description	Sonia Butalia,1– 4 Gilaad G Kaplan,1– 3 Bushra Khokhar,2 Sydney Haubrich,5 Doreen M Rabi1– 4,6 1Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; 2Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; 3O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; 4Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; 5Ward of the 21st Century, University of Calgary, Calgary, Alberta, Canada; 6Department of Cardiac Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, CanadaCorrespondence: Sonia ButaliaDivision of Endocrinology and Metabolism, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road SW, Calgary, Alberta T2T 5C7, CanadaTel +1 403-955-8327Fax +1 403-955-8249Email sbutalia@ucalgary.caAbstract: Type 1 diabetes is the result of autoimmune-mediated destruction and inflammation of the insulin-producing β-cells of the pancreas. The excess morbidity and mortality from its complications coupled with its increasing incidence emphasize the importance to better understand the etiology of this condition. It has a strong genetic component, but a genetic predisposition is not the sole contributor to disease development as only 30% to 50% of identical twins both develop the disease. In addition, there are multiple lines of evidence to support that environmental factors contribute to the pathogenesis of type 1 diabetes. Environmental risk factors that have been proposed include infections, dietary factors, air pollution, vaccines, location of residence, childhood obesity, family environment and stress. Researchers have conducted many observational studies to identify and characterize these potential environmental factors, but findings have been inconsistent or inconclusive. Many studies have had inherent methodological issues in recruitment, participation, defining cases and exposures, and/or data analysis which may limit the interpretability of findings. Identifying and addressing these limitations may allow for greatly needed advances in our understanding of type 1 diabetes. As such, the purpose of this article is to review and discuss the limitations of observational studies that aim to determine environmental risk factors for type 1 diabetes and propose recommendations to overcome them.Keywords: type 1 diabetes, risk factors, epidemiology
format	article
author	Butalia S Kaplan GG Khokhar B Haubrich S Rabi DM
author_facet	Butalia S Kaplan GG Khokhar B Haubrich S Rabi DM
author_sort	Butalia S
title	The Challenges of Identifying Environmental Determinants of Type 1 Diabetes: In Search of the Holy Grail
title_short	The Challenges of Identifying Environmental Determinants of Type 1 Diabetes: In Search of the Holy Grail
title_full	The Challenges of Identifying Environmental Determinants of Type 1 Diabetes: In Search of the Holy Grail
title_fullStr	The Challenges of Identifying Environmental Determinants of Type 1 Diabetes: In Search of the Holy Grail
title_full_unstemmed	The Challenges of Identifying Environmental Determinants of Type 1 Diabetes: In Search of the Holy Grail
title_sort	challenges of identifying environmental determinants of type 1 diabetes: in search of the holy grail
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/612f8f84a0e04b65b3d16ab6d4838853
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The Challenges of Identifying Environmental Determinants of Type 1 Diabetes: In Search of the Holy Grail

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