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Understanding the extremely early onset of Type 1 diabetes

Project summary

Extreme early onset Type 1 diabetes 

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 for the immune system to go rogue at such a young age. Dr Oram hopes that understanding why this rare form of Type 1 diabetes develops will shed a light on why Type 1 diabetes develops in general.

Background to research

Type 1 diabetes often arises 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 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 under six months was not Type 1 diabetes (caused by an immune attack), but neonatal diabetes, caused by a single genetic spelling mistake that affects insulin-producing beta cells.  Scientists at the University of Exeter Medical School have found a very rare group of children diagnosed under the age of one year, who almost certainly have an immune attack against the pancreas and, therefore, Type 1 diabetes. This raises questions of how and why did the immune system start to go wrong in these children, and when did it begin? Understanding how extremely early onset Type 1 diabetes develops may be very important. This is because different strategies to stop Type 1 diabetes from progressing may be needed for those who develop Type 1 diabetes early in life compared to those who are diagnosed later on.

Research aims

Dr Oram will be studying people diagnosed with Type 1 diabetes before the age of 12 months, people diagnosed with Type 1 diabetes at more typical ages (between one and ten years), and people with neonatal diabetes. He will look for any differences, searching for factors that may have influenced this extremely early onset of Type 1 diabetes. Is it unusual genetics, do the mother’s genes have any influence, and are their immune systems more active? Dr Oram will also look for any unusual clinical features (such as complications during pregnancy or other conditions they might be living with) and any evidence that a viral infection may have been involved.

Potential benefit to people with diabetes

At Diabetes UK 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 against the pancreas develops in children of a very young age and, in turn, it could inform future efforts to design therapies to prevent or stop Type 1 diabetes.

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