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International diabetes study receives SEK 40 million to continue

The TEDDY Study has increased our knowledge about what happens prior to the onset of autoimmune diabetes (type 1 diabetes) and has shown that a stomach infection can trigger coeliac disease. Lund University in Sweden has now received just over SEK 40 million from the American National Institutes of Health (NIH) to continue the TEDDY Study for another five years.

“We have large volumes of data to analyse and report back to all the families participating in the TEDDY Study, the public and the research community. In addition to interviews based on questionnaires, blood samples are taken during each visit. We also collect urine samples, toenail clippings, nasal wipe samples, a milk tooth and stool samples. During a three day-period, twice a year, the family records what the child eats. Everything is to be examined and analysed”, says senior professor Åke Lernmark, head of the Swedish TEDDY, which started in 2004.



Type 1 diabetes is an autoimmune disease, which means that the body’s immune system attacks and destroys its own insulin-producing cells. This process is indicated by the formation of autoantibodies in the blood. Thanks to the TEDDY Study, it is now possible to predict the onset of the disease by studying when various autoantibodies develop. However, the mechanism that makes the autoantibodies appear is still unknown.



“Together with world-leading laboratories and new technology, the grant enables us to investigate this”, explains Åke Lernmark.



The disease differs considerably from other types of diabetes, and to ensure that it does not get confused with type 2 diabetes, which has completely different causes, the researchers want to change the name of type 1 diabetes.



“We would rather call it ‘autoimmune diabetes’, as this is a more correct designation for the disease”, says Åke Lernmark.



Researchers in the TEDDY Study have found connections between the amount of gluten in the first two years of life and developing coeliac disease, and shown that a stomach infection can trigger the disease.



The TEDDY Study has also generated a large number of research studies and doctoral theses. A further two studies will begin in the autumn, this time with an aim to find ways to prevent, or impede, the onset of autoimmune diabetes or coeliac disease. POInT investigates whether it is possible to acclimatise the immune system to insulin by giving children insulin orally, while PreCiSe examines whether the emergence of a biomarker can be prevented with a gluten-free diet or probiotics.



“Thanks to the children in TEDDY, we are in the process of rewriting the map for autoimmune diabetes and coeliac disease”, concludes Åke Lernmark.



 

Facts – these are the conclusions of the TEDDY Study so far:

 



that a first autoantibody against insulin (IAA) was found in 4% of the children. Most of the children were just 1–3 years old. Prior to the autoantibody, the parents reported that the child had had an infection. Few children developed IAA as a first autoantibody after the age of 6. 



that other children (also 4%) developed an autoantibody against GAD (GADA) as their first autoantibody, but it came later and continues to appear as first autoantibody even among  teenagers. An infection often precedes the antibody.



that the genes for developing IAA or GADA as first autoantibody are completely different!

that within one year of the first autoantibody, 60 of 100 children (60%) developed a second autoantibody.



that 10% of Swedish children in TEDDY have been diagnosed with coeliac disease. The risk of developing gluten autoantibodies and then coeliac disease was affected by gastrointestinal infections and gluten intake, but was reduced after rotavirus vaccination.

that antipyretic medicine – such as Alvedon or Ipren – did not affect the risk of developing a first autoantibody. The risk of IAA as first autoantibody was, however, lower if the child was given stomach drops or probiotics during the first month of life. 



that participating in TEDDY removed the risk of being taken ill with life-threatening symptoms once a diabetes diagnosis had been received. To date, 4% of Swedish children in TEDDY have developed diabetes. 




 

Facts about the TEDDY Study (The Environmental Determinants of Diabetes in the Young Study)

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Lund University Diabetes Centre, CRC, SUS Malmö, Jan Waldenströms gata 35, House 91:12. SE-214 28 Malmö. Telephone: +46 40 39 10 00