Cited by 676Diabetes and associated disordersDiabetes Management and ResearchT-cell and B-cell Immunology

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Environmental risk factors for type 1 diabetes

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Rewers, Marian, Ludvigsson, Johnny·2016·The Lancet

DOI 10.1016/s0140-6736(16)30507-4PMC PMC5571740

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Abstract

The incidence of type 1 diabetes has risen considerably in the past 30 years due to changes in the environment that have been only partially identified. In this Series paper, we critically discuss candidate triggers of islet autoimmunity and factors thought to promote progression from autoimmunity to overt type 1 diabetes. We revisit previously proposed hypotheses to explain the growth in the incidence of type 1 diabetes in light of current data. Finally, we suggest a unified model in which immune tolerance to β cells can be broken by several environmental exposures that induce generation of hybrid peptides acting as neoautoantigens.

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Authors: Rewers, M., & Ludvigsson, J.
Affiliations: University of Colorado Anschutz (US)
Linköping University (SE)
Corresponding author: Ludvigsson, Johnny
ORCID: Rewers, Marian
Ludvigsson, Johnny
Venue: The Lancet
Publisher: Elsevier BV
Published: 2016-06
Volume: 387
Issue: 10035
Pages: 2340-2348
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(16)30507-4
PMC: PMC5571740
OpenAlex: W2416473596
Semantic Scholar: cfb08c15990c940ca28c917c4b6cd3743c3d269c
Cited by: 676
References: 136
Citations by year: 2026: 29 · 2025: 49 · 2024: 75 · 2023: 83 · 2022: 94 · 2021: 84 · 2020: 88 · 2019: 53 · 2018: 69 · 2017: 45 · 2016: 7
FWCI: 7.81
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Diabetes and Digestive and Kidney Diseases (DK 32493, R01DK032493, R37DK032493)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
Keywords: type 1 diabetes, environmental risk factors, islet autoimmunity, disease incidence, hybrid peptides, environmental exposure
MeSH terms: Animals, Autoantigens, Birth Weight, Breast Feeding, Diabetes Mellitus, Type 1, Diet, Environment, Fatty Acids, Unsaturated, Growth, Humans, Hygiene, Infant, Infant Food, Milk, Risk Factors, RNA, Toxins, Biological, Vaccines, Vitamin D, Autoimmunity, Insulin-Secreting Cells

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