Introduction
Diabetes is a serious health concern for people of all ages. There are distinct epidemiology, developmental considerations, pathophysiology, and therapy between pediatric-onset diabetes and adults. Nevo-Shenker et al. (2020) observed that the incidence rate of type 1 diabetes globally is rising at a rate of 2 to 5% annually. The increasing cases of type 1 diabetes create the need for increased screening of the disease so that families can undertake the necessary management measures. The prevalence rate of type 1 diabetes raises the question of the role of genetic factors in the increasing cases of this illness.
Genetic Factors Predictors
Every child is born with a unique set of genes passed down from older generations in the family. Some children possess genetic factors that make them vulnerable to specific illnesses, such as type 1 diabetes. Traversi et al. (2020) noted that this disease is caused by absolute immune deficiency due to the destruction of β-cell. In a body, insulin is synthesized by these β-cells through a response to glucose stimulus (Chiang et al., 2018). Therefore, the destruction of these insulin production cells leaves the children vulnerable and weaker autoimmune response, forcing them to become dependent on external support. Some children can have classic symptoms at this stage, including weight loss, blurred vision caused by swelling lens due to osmotic effects, weight loss, perineal candidiasis, and polydipsia (Chiang et al., 2018). At this point, it becomes possible to diagnose type 1 diabetes by measuring blood glucose. Diagnosing the disease enables health professionals to take precautionary measures to protect the children because metabolic conditions might deteriorate rapidly when left unmanaged for long. Insulin replacement is the preferred treatment, indicating that genes may trigger type 1 diabetes.
The other evidence pointing towards the role of genetic factors is the increased risk children and relatives of type 1 diabetes patients. Findings from a study by Redondo et al. (2017) noted that the risk of relatives with patients increases by 0.4% compared to the general population. Contrasting this figure with the siblings of patients, the prevalence rises to 6-7% (Redondo et al., 2017). This figure notes that the genes passed down from parents to children significantly expose them to type 1 diabetes. The rate of 0.4% also suggests that relatives are 15-20 times likely to contract the disease than other people. These assertions are supported by Traversi et al. (2020), who noted that genetic susceptibility of type 1 diabetes is higher in children when the father is affected than the mother. Primavera et al. (2020) and Redondo et al. (2017) also observed concordance rate among identical twins is 25-50%. This value indicates that as the twins have the same traits and genetics, the probability of contracting type 1 diabetes is higher than other people.
Studying serological biomarkers also reveals a specific pattern suggesting some children are predisposed to type 1 diabetes. Serology explores serum and bodily fluids, essential in the diagnostic identification of antibodies. Primavera et al. (2020) observed serological biomarkers influence autoimmunity and beta-cell dysfunction, helping in the progression of the disease. As noted, β-cells are essential in the synthesis of insulin that regulates glucose in the blood. The islet autoantibodies include autoantibodies against insulin, autoantibodies against insulin-associated antigen, autoantibodies against glutamic acid decarboxylase, islet cell antibodies, and autoantibodies against zinc-transporter 8, predict progression of type 1 diabetes (Primavera et al., 2020). Considering that type 1 diabetes risk for children with one islet autoantibody was 14.5%, and it increased to 69.7% with multiple autoantibodies (Primavera et al., 2020). This change in prevalence rate as islet autoantibodies increases suggests that genes influence the prevalence rate of type 1 diabetes.
The analysis of age and genetic factors in predicting type 1 diabetes also reveals a possible link to the rise of the disease among children. The studies also link the presence of human leukocyte antigen (HLA) represents a genetic risk of 50% (Primavera et al., 2020), and the genotypes are more prevalent among younger patients (Redondo & Concannon, 2020). Therefore, scientists explore the associations between HLA and non-HLA genotypes as a predictor of the disease. For instance, diagnosis of type 11 diabetes among children is associated with the single-nucleotide polymorphism and 6q22.33 region, which contain genes encoding tyrosine phosphatase receptor k protein and thymocyte-expressed molecule (Redondo & Concannon, 2020). The age distribution diagnosis has provided specific data that shows the role of genes in this disease.
Environmental Factors
Despite the evidence suggesting that some children are genetically predisposed, other factors trigger type 1 diabetes. Research suggests diet, especially gluten, in the first months of a child influences development of the disease. An experiment noted that animals that consumed gluten for 320 days were 64% more likely to develop type 1 diabetes than those that took a gluten-free diet (Esposito et al., 2019). Gluten-free meals help decrease intestinal permeability, which is essential as it protects the intestines against the peptides that might lower pancreatic autoimmunity. It also helps in reducing beta-cell stress, increasing the preservation of islets. Similarly, children who began consuming cow milk and infant formula before 3 months developed a moderate risk of type 1 diabetes than those who breastfed throughout (Esposito et al., 2019). While the risk is not definitive, it helps establish that diet and gluten food raises the disease’s risk.
Other environmental factors also contribute towards the development of type 1 diabetes. Rewers and Ludvigsson (2016) noted that there exists a possibility that bacterial and viral infections cause the disease. For example, enteroviruses affect human pancreatic islets and have been discovered in many patients diagnosed with type 1 diabetes. Esposito et al. (2019) noted exposure to certain antibiotics and pentamidine are linked with abnormal glucose metabolism. Antibiotics modify gut microbiota composition resulting in an abnormal immune response that accelerates the development of type 1 diabetes. These environmental predictors may activate genetic factors that contribute to this disease.
Conclusion
The rising cases of type 1 diabetes in children are worrying, and society should act swiftly to alter this public health issue. The paper has identified various genetic and environmental predictors of this disease. It is also clear that diabetes does not discriminate against race or age, and every individual should take necessary measures to curb the spread of this illness. First, parents should be proactive in ensuring the children are screened earlier, especially if a child has a relative with type 1 diabetes and specific symptoms linked to the disease. Early diagnosis is helpful because appropriate treatments can be administered to manage diabetes. Additionally, education to raise awareness about the disease can lower the prevalence rate by avoiding environmental risk factors. As the tests are expensive, healthcare facilities in conjunction with the government should make screening affordable and accessible to all people by subsidizing the service.
References
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Esposito, S., Toni, G., Tascini, G., Santi, E., Berioli, M. G., & Principi, N. (2019). Environmental factors associated with type 1 diabetes. Frontiers in Endocrinology, 10, 1-12.
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Rewers, M., & Ludvigsson, J. (2016). Environmental risk factors for type 1 diabetes. The Lancet, 387(10035), 2340-2348.
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