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This paper will discuss the role of environmental factors as risks of Type I Diabetes. Diabetes –a metabolic disease is the most common health condition affecting the population of several nations. It arises from the inability of the body to regulate the amount of sugar (glucose) in the blood. Diabetics either do not produce enough insulin (Type I) or are not able to use the insulin properly (Type II). Almost 10% of people in the United States of America are affected by the condition and the number continues to grow. Type I Diabetes, popularly known as Juvenile Diabetes, was believed to be the most prevalent in children but it does affect a few adults as well. There are no specific reasons for the development of Type I Diabetes in children; in adults it can caused by progressive failure of pancreatic beta cells.

Type I Diabetes is an ‘autoimmune’ disorder wherein the immune system of the body reverses its functions and starts attacking the pancreatic beta cells and causing a deficiency in insulin. Genetic conditions/irregularities account for 30-40% of the cases and other environmental factors – including diet account for 60-70% of the cases.

In this paper we discuss the role of the early introduction of solid foods into an infant’s diet, Vitamin C deficiency, breast milk and environmental factors as a possible risk of Type I Diabetes.

Environmental Factors

There are several environmental factors that play a significant role in the causation of Type I Diabetes; these include viral infections and Diet. Viral infections include effects of childhood immunizations, mumps viruses, rotavirus and many more. Diet can pose problems with regard to breast feeding, early introduction of cow’s milk, introduction of solid foods, Vitamin D, Ascorbic Acid, Vitamin E, Zinc and Omega-3 fatty acids. We concentrate on the dietary implications of breast feeding, early introduction of cow’s milk and gluten in solid foods and Vitamin D.

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Breast Milk and Early Introduction to Cow’s Milk

It has been recommended that infants be exclusively breastfed for a period of 4 to 6 months after which they can commence eating solid food. Breast milk contains up to one million cells per millimetre and is abundant in protective immunoglobulin. The molecules of the most abundant type of immunoglobulin – secretory IgA bind themselves to pathogens (if any) and prevent them from entering the tissues lining the infant’s gastrointestinal tract. In the first few months of their lives, infants’ intestines are highly permeable and allow proteins and other foreign molecules to enter into the blood. This is where IgA comes into play and provides unmatched protection against infections and allergens. Babies do not produce their own IgA until they are six to nine months old. Various studies have proved that babies fed on breast milk are able to fight diseases and infections more efficiently than babies that have been introduced to other diets at the expense of breast milk.

Two of the most popular alternatives to breast milk are solid foods (cereal/gluten rich food) and cow’s milk. Cow’s milk contains beta-lactoglobulin - a protein not found in breast milk. Beta-lactoglobulin is known to trigger autoimmunity in infants which in turn leads to Juvenile Diabetes. Because it is structurally similar to the human protein glycodelin (which helps control the production of T-cells that guard the body against infections and diseases) an infant’s immature immune system may destroy glycodelin in an effort to destroy the cow’s milk protein – which it recognizes as foreign. This could result in an over-production of T-cells which attack beta pancreatic cells and, therefore, trigger juvenile diabetes. That is why, infants who are exposed to cow’s milk before their first birthday are at an increased risk of being affected by Type I Diabetes.

Introduction to Solid Foods

When solid foods containing gluten are introduced in the infant’s diet too soon they induce the production of antibodies that eliminate insulin producing cells. This leads to an inability to produce insulin and subsequently Type I Diabetes Mellitus. Wheat gluten if introduced before 3 months of age and after 7 months of age can lead to beta cell autoimmunity. It, therefore, is important that solid foods such as cereals and other foods rich in gluten be introduced at the right time –neither too soon nor too late.

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According to American and German studies conducted on Diabetics, gluten is a diabetogenic and increases the risk of Beta cell autoimmunity. The American survey also suggests that both, gluten containing and non-gluten containing cereals pose a risk for Beta cell autoimmunity.

Role of Vitamin D

Breast Milk provides all the nutrients and antibodies required by a child except Vitamin D. Avoidance of the sun or a lack of exposure to sunlight triggers insufficiency ofVitamin D in the organism; that is why, it is perceived to a leading cause of Diabetes. It has been observed that Type I diabetes is prevalent in areas at high latitudes and mostly diagnosed during fall or winter when there is little or no exposure to sunlight. A comparison of children in Finland and Venezuela clearly points to the importance of sunlight in preventing Juvenile Diabetes. Children in North Finland at 67 degrees latitude are 400 times more susceptible to Juvenile Diabetes than children in Venezuela at 6 degree latitude.

During fetal development if there is not sufficient Vitamin D available to suppress D cells, there can be a triggering of antibodies and an inflammatory response which can lead to the destruction of beta-pancreatic cells and Type I Diabetes.

Genetic Irregularities

Few years ago it was believed that Diabetes was hereditary. However, recent research has shown that less than 15% of people with Type I Diabetes have an affected first degree relative. Research has also revealed that genes are a very minor contributing factor to the risk of developing Diabetes. Only 10% of Type I Diabetics have a family history of Diabetes.  HLA genes hold chains of amino acids on the cell surface. These molecules help immune cells analyse the chains and attack the  inappropriate ones. If individuals inherit certain alleles  of HLA genes, there is an increased probability of their immune cells attacking their body cells – beta pancreatic cells and causing Type I Diabetes.

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Type I Diabetes cannot be entirely attributed to hereditary conditions or genetic irregularities. Environmental factors play a major role in development of the disease. A combination of genetic irregularities and environmental factors multiplies the risk. As was discussed in the paper, it is extremely important to be aware of the implications of an infant’s diet. Breast milk is the most natural defense against the condition. It protects the baby’s intestine and keeps allergens and infections at bay. When there is an attempt to go against the ‘to be exclusively breast fed till six months of age’ rule and when infants are introduced to other foods like cow’s milk or solid foods rich in wheat gluten before their immune systems are developed, there are problems.

Vitamin D deficiency is another leading cause of Type I Diabetes. Researches on Type I Diabetics in Finland (one of the most affected areas) have proved that a determined inclusion of Vitamin D has considerably brought down the number of people affected by Type I Diabetes.

It is also worth mentioning that people with genetic irregularities need not necessarily be afflicted by the condition. There are several people with HLA alleles who do not suffer from Type I Diabetes. However children who have been deprived of breast milk, weaned off breast milk earlier than six months, introduced to formulas, cow’s milk or gluten rich solid foods ahead of time have proven to be affected by the condition.

In conclusion, genes or hereditary factors are not the main cause of Type I Diabetes.

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