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Understanding the extremely early onset of Type 1 diabetes

Project summary

Dr Oram will study an extremely rare form of Type 1 diabetes, which develops in children before 12 months of age. He wants to understand how it is possible to develop an immune attack against beta cells at such a young age. Dr Oram hopes that identifying the reasons behind this rare form of Type 1 diabetes, will shed a light on why Type 1 diabetes develops in general.

Background to research

Type 1 diabetes is regarded as a condition arising in childhood with an average age of diagnosis of 13 years. But actually the age of diagnosis ranges from very young children to late adulthood. We really don’t understand why some people are diagnosed as children and others as adults. 

Until recently it was thought that almost all diabetes diagnosed in children less than 6 months was not Type 1 diabetes caused by an immune attack, but neonatal diabetes caused by a single genetic spelling mistake that affected insulin-producing beta cells. Recently scientists at University of Exteter Medical School have identified a very rare group of children diagnosed under the age of one year, who almost certainly have immune attack and Type 1 diabetes.  

This raises questions of how, why and when did the immune system start to go wrong in these children. Understanding the mechanism for extremely early onset of Type 1 diabetes may be very important, as strategies to intervene after people get Type 1 diabetes may differ depending on the age they were diagnosed. 

Research aims

Dr Oram will be comparing people diagnosed with Type 1 diabetes before the age of 12 months to people with Type 1 diabetes diagnosed at more typical ages (between one and ten years), as well as people with neonatal diabetes, which is not caused by an immune attack. He will investigate what factors may have influenced this extremely early onset of Type 1 diabetes: is it unusual genetics, whether mother’s genes have any influence, and whether their immune systems are extremely active. Dr Oram will also look for any unusual clinical features (such as pregnancy complications and other diseases) and any evidence that a viral infection may have contributed to the development of this extremely early onset of Type 1 diabetes.

Potential benefit to people with diabetes

We are committed to understanding the causes of Type 1 diabetes and finding a cure. This project will provide important insights into how the immune attack develops in children of a very young age and in turn it could inform future efforts to design therapies for Type 1 diabetes. 

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