UMWELTFAKTOREN IN DER PATHOGENESE DES TYP-1-DIABETES

Accumulating evidence suggests that type 1 diabetes results from a complex interaction of distinct risk-associated genes and environmental factors in an individually variable combination. The incidence of the disease is increasing worldwide, a fact that cannot be explained by rising transmission of 'diabetes-genes'. In many populations, early exposure to cow milk proteins and a short duration of breast feeding have been identified as diet-related risk factors. Perinatal determinants such as Sectio caesarea, higher maternal age at delivery and socio-economic factors, e.g. a higher social status of the parents are discussed as further risk factors. Viral infections have also been implicated in the pathogenesis of IDDM, although this hypothesis is still lacking strong evidence. A new finding is that infections and vaccinations may have protective effects as well. Autoimmunity in type 1 diabetes mellitus can be described as an imbalance of the immune-system between immunostimulation and immunosuppression.