Environmental risk factors

Evidence suggests an environmental influence is at work in determining who gets type 1 diabetes, though the relationship is unclear. Among Caucasians, diabetes risk varies geographically. In general, the risk is higher in Northern Europeans than Southern Europeans--though Sardinians in the Mediterranean also are at elevated risk. In recent decades, there has been an upswing in type 1 diabetes in the United States and Europe. While Asians generally have a much lower incidence of type 1 diabetes, Japan is also experiencing a rise in cases. Such changes are most likely linked to some environmental or behavioral factor. Possibilities include climate, exposure to some virus, and infant diet.

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Temporal clusters of type 1 diabetes cases (those that occur around the same time--whether within families, a school, or a geographical region) have also prompted people to suspect an environmental agent. However, given that the development of diabetes takes many years in most cases, as the body's immune system malfunctions and begins destroying the body's insulin-producing cells, a clustering in time seems more likely due to chance than a common cause.