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.

Reference:

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.