It was previously thought that infants who are less than six months old could only develop neonatal diabetes – which is caused by a genetic mutation that affect the pancreas cells that produce insulin.
But the researchers now believe younger babies can also develop type 1 diabetes, a condition where the body’s own immune system mistakenly destroys the same insulin-producing cells.
They say the findings, published in the journal Diabetologia, raise the question of whether the immune attack behind type 1 diabetes could begin in the womb for some infants, leading to reduced insulin production and consequently lower birth weight, thus “challenging what we know about the immune system”.
Dr Elizabeth Robertson, director of research at Diabetes UK – which co-funded the research, said: “By revealing for the first time the existence of type 1 diabetes in the very first few months of life, these important findings rewrite our understanding of when the condition can strike and when the immune system can start to go wrong.
“We now need to piece together how and why type 1 diabetes can develop at such a young age.
We now need to piece together how and why type 1 diabetes can develop at such a young age
“This could also unlock crucial insights into causes of type 1 diabetes more generally in people of all ages, and will be essential to develop treatments that stop or prevent this life-altering condition in babies.”
A team of researchers, which included scientists from the University of Exeter and King’s College London, looked at three groups of children: 166 diagnosed with type 1 diabetes before six months of age, 164 with confirmed neonatal diabetes and 152 diagnosed with type 1 diabetes at an older age (6–24 months).
They found that combination of a high genetic risk for type 1 diabetes, signs of an immune attack on insulin-producing cells and low insulin-producing capacity, was associated with type 1 diabetes in children under six months.
Dr Matthew Johnston, Exeter Centre of Excellence in Diabetes (ExCEED) E3 Research Fellow at the University of Exeter, said: “This study proves that type 1 diabetes can present in the first few months of life, and in a tiny subset of infants may even begin before birth.
“We also found that diabetes diagnosed so young was associated with rapid progression to complete destruction of insulin producing beta cells.”
As part of the next steps, the team want to study very early onset type 1 diabetes in greater detail, so they can “understand how it might be possible for the immune system to go rogue before it is fully formed”.
