What causes Juvenile Diabetes or Type I Diabetes
Mellitus is not completely understood. It is believed that it develops due to a
complex interplay between genetic
predisposition, immune system and environmental factors. In recent years we
have seen an increased prevalence of Juvenile Diabetes, especially in children
below the age of 5-years. Europe alone has seen a 3.9% increase. Previous
studies have suggested that maternal
entero-virus infection during pregnancy increases the risk of offspring
developing Type I -Diabetes during adolescence or young -adulthood.
Entero-virus infections may initiate and accelerate the beta-cell damaging
process leading to diabetes. Entero-virus are
small viruses which are made of Ribo Nucleic Acid (RNA) and protein.
Besides the 3-polio viruses, there are 60 types of cold related viruses that
can cause infection and are more prevalent in summer and during the fall.
Entero-virus cause an estimated 10-15 million or more symptomatic infections
per year in the United States. RNA from entero-virus can be detected in stools,
tissue and blood samples.
Statistics reveal an increased incidence of
diabetes following entero-virus epidemics. Observational studies have shown
that entero-virus infection increases the risk of pancreatic islet autoimmunity
or type 1 diabetes mellitus. But systematic review of serological studies had
found no association between pancreatic islet autoimmunity and type 1 diabetes
mellitus.
Therefore,
scientists wanted to review the
association between current entero-virus infection and development of
autoimmunity or type 1 diabetes mellitus on the basis of molecular studies.
For this purpose they went through several studies which were limited to humans
(animal studies were not considered) and that measured entero-virus RNA or
viral capsid protein in blood, stool or tissue of patients with pre-diabetes
and diabetes; and used molecular methods for viral detection. Depending upon
whether autoimmunity or type 1 diabetes was the outcome of the study the
results were classified into two groups- pre-diabetes and diabetes. Using the
Mantel-Haenszel method scientists calculated unadjusted odds ratio with 95%
confidence intervals and P values for entero-virus identification in patients
with pre-diabetes versus no diabetes and patients with diabetes versus no
diabetes.
They found that there was
an association
between Type I Diabetes Mellitus
and entero-virus infection, with a more
than 9 times the risk of infection in cases of diabetes and thrice the risk in
children with pancreatic islet autoimmunity. Persistent entero-virus infection
is also common among patients with Type
I Diabetes.
References :
British Medical Journal
http://www.bmj.com/content/342/bmj.d35.full
Source: Medindia
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