Some of the results of The Environmental Determinants of Diabetes in the Young (TEDDY) study were revealed at the American Diabetes Association Congress, in Orlando, this past month. Dr Louise Johnson tells us more.

Aim of TEDDY

TEDDY study is looking for the causes of Type 1 diabetes mellitus (T1DM).

About T1DM

T1DM used to be called childhood diabetes or insulin-dependent diabetes. It occurs when special cells in the body, called the beta cells of the pancreas, are destroyed by the body’s infection fighting cells, called immune cells. When these beta cells are destroyed, the body cannot produce the hormone – insulin.

Insulin is needed for the body to effectively use food as an energy source. Insulin helps keep the sugar level in the blood normal. If there is no insulin in the body, the sugar in the blood becomes high and this makes someone sick. Children with Type 1 diabetes must take insulin shots and monitor their blood sugar levels several times a day to stay alive and healthy.

What does research say?

Research tells us that children who are diagnosed with diabetes have certain kinds of genes. Other children who have these genes are at higher risk for getting diabetes. However, not all children who are at a higher risk get diabetes.

It has been suggested that something happens that ‘triggers’ or causes a child with higher-risk genes to develop diabetes. It is the purpose of TEDDY study is to find out what the triggers are that cause children to develop diabetes.

The long-term goal of TEDDY study is the identification of infectious agents, dietary factors, or other environmental agents, including psychosocial factors that trigger T1DM in genetically susceptible individuals or which protect against the disease. Identification of such factors will lead to a better understanding of disease pathogenesis and result in new strategies to prevent, delay, or reverse T1DM.

TEDDY results

The study enrolled all American, Germany, Sweden and Finland babies from birth up to four months of age with a specific HLA gene in that population, or babies with a first degree relative with Type 1 diabetes. This would be a baby with a sibling or mother or father with Type 1 diabetes. These babies were followed up for 15 years.

TEDDY study showed:

• Different gut organisms (microbiome) in different countries.
• Diet (high in fat and high in gluten in the first six months of life when solid foods are introduced.) This diet alters the bacteria in the gut and can increase the risk of auto-antibodies.
• Probiotics early in life might reduce auto-antibodies to those at risk.
• It is vital to feed your children (from early) a healthy low-fat, low-gluten diet, and to only use antibiotics if really necessary.

The new millennium diabetics

The new millennium diabetics (from 2000) all have the value of new technology on their side. The improvement of newer insulin, better glucose meters and continuous glucose monitors (CGM). These are all currently available in South Africa.

The availability of tablets, as an add-on to background insulin in Type 1 diabetes, showed promising results at the ADA congress. These new tablets will soon be available. Taking the facts into consideration, it suffices to conclude the treatment of diabetes will take a diverse approach in both the physical and mental realm.

MEET OUR EXPERT

Dr Louise Johnson is a specialist physician passionate about diabetes and endocrinology. She enjoys helping people with diabetes live a full life with optimal quality. She is based in Pretoria in private practice.