T1D Autoimmunity Linked to Nutritional Factors During Infancy

TRIGR (Trial to Reduce Insulin Dependent Diabetes Mellitus in the Genetically at Risk) is an international, randomized, double-blind, controlled intervention trial evaluating whether weaning infants to an extensively hydrolyzed formula will decrease the risk of T1D later in childhood. In this pilot study (involving a small subset of the total enrolled population) 230 Finnish infants were randomly assigned at weaning to either an extensively hydrolyzed formula or a conventional cow milk-based formula before 8 months of age. Infants remained on either formula for 6-8 months and were then followed until age 10. The follow-up analysis of this subset at age 10 showed that the use of an extensively hydrolyzed formula at weaning decreased by 50% the appearance of one or more autoantibodies in the study children. The full-scale study will be completed in 2017. While incomplete, these interim data from the pilot study provide encouraging data about the role of infant nutritional factors in T1D autoimmunity.


Knip M, Virtanen SM, Becker D, Dupré J, Krischer JP, Åkerblom HK; TRIGR Study Group. Early feeding and risk of type 1 diabetes: experiences from the Trial to Reduce Insulin-dependent diabetes mellitus in the Genetically at Risk (TRIGR). (2011). Am J Clin Nutr. Dec;94(6 Suppl):1814S-1820S.

Ramifications for Individuals with Type 1 Diabetes:

The results from this small pilot study suggest that it may be possible to reduce spontaneous beta cell autoimmunity in at-risk infants by nutritional intervention during infancy. This provides an attractive preventive strategy, because it can be implemented relatively easily as a public health measure.

JDRF Involvement:

JDRF supported the TRIGR study during its first two years of operation and continues to follow the studys progress and updates by attending TRIGRs biannual meetings.