Early determinants of type 1 diabetes: experience from the BABYDIAB and BABYDIET studies.

Type 1 diabetes is an immune-mediated disorder that results from progressive destruction of the islet β cells. A genetic susceptibility for the development of islet autoimmunity and type 1 diabetes is well documented, and an environmental influence is assumed. Prospective studies from birth have shown that islet autoimmunity occurs very early in life, which implies that fetal or postnatal environmental factors may program the development of islet autoimmunity. In this overview, results from the BABYDIAB study, a prospective study from birth on the natural history of type 1 diabetes, and the BABYDIET study, a dietary intervention study, are discussed with a focus on the role of a diabetes environment in utero and the role of early gluten exposure on islet autoimmunity risk in children.