Scientists Discover Early Warning Sign of Diabetes in Children

A child’s gut bacteria may contain an early warning sign for type 1 diabetes, according to new research. Children whose gut microbiomes — the bacteria and other microorganisms living in the digestive tract — developed more slowly than those of other children in the study during the first two years of life had about three times the risk of developing type 1 diabetes or the autoimmune process that precedes it, researchers from Harvard and MIT reported Monday in Nature Metabolism. The finding could help doctors identify children at higher risk before symptoms appear. Earlier detection would give doctors more time to intervene, since treatment can delay progression of type 1 diabetes by up to two years. More research is needed, however, to determine whether the slower-developing microbiome is a cause for type 1 diabetes or an early sign of changes already taking place.The higher risk also could not be explained by differences in breastfeeding or when children began eating solid foods. The association remained after researchers accounted for those factors, along with family history, genetics, and other factors that could influence the microbiome or diabetes risk.Type 1 diabetes is an autoimmune disease in which the immune system destroys insulin-producing cells in the pancreas. About 8.5 million people worldwide are estimated to have the disease, which can develop at any age but commonly begins in childhood or adolescence. Genetics play a significant part: around 50 percent of the risk for type 1 diabetes is considered to be genetic. Genetics, however, do not fully explain who develops the disease. Many people who carry genetic variants associated with type 1 diabetes never receive a diagnosis, leading scientists to search for environmental factors. One area of interest is the gut microbiome, the collection of microorganisms that lives in the digestive tract, playing a role in metabolism and immunity. The new research used data from The Environmental Determinants of Diabetes in the Young (TEDDY) study, an ongoing project that began in 2004 and investigates why some children with high genetic risk of type 1 diabetes develop the disease while others do not. Researchers analyzed 12,151 sequenced stool samples from 887 children, with most sampling happening during the first four years of life and some continuing through age six. These samples were compared with records showing whether the children had developed islet autoantibodies, an early sign that the immune system has begun attacking insulin-producing cells, or were diagnosed with type 1 diabetes.To examine how the gut microbiome developed over time, researchers focused on 594 children who had enough repeated samples to track changes over time. They identified three patterns: Early Matured, Late Matured, and Early Plateaued. A child’s microbiome does not remain the same as they grow. During infancy and early childhood, some bacteria become more or less common as a child’s diet changes, while the overall microbiome becomes more diverse. The researchers examined how quickly and extensively those changes occurred in each child. Children in the Early Matured group experienced rapid changes in their gut microbiomes during roughly the first 400 days before the microbiome became relatively stable. Children in the Late Matured group changed more slowly at first, but their microbiomes later developed more rapidly and caught up with the Early Matured group.For the Early Plateaued group, the microbiomes remained less diverse and changed relatively little from their initial composition before reaching a plateau. This pattern was associated with the greatest diabetes risk.Compared with children in the Early Matured group, children with an Early Plateaued microbiome had 3.21 times the risk of developing islet autoimmunity or type 1 diabetes and 3.33 times the risk compared with children in the Late Matured group. The association remained even after researchers accounted for other factors that could affect diabetes risk or the microbiome, including family history, sex, delivery method, breastfeeding, antibiotic use, the introduction of solid foods and genetic background. When researchers analyzed islet autoimmunity and type 1 diabetes diagnoses separately, the Early Plateaued pattern was associated with higher risk in both groups.

Scientists Discover Early Warning Sign of Diabetes in Children

Scientists Discover Early Warning Sign of Diabetes in Children

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