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Diabetes could begin in the womb



Type 1 diabetes can develop in babies before they reach six-months-old and may begin in the womb, according to a study co-funded by Diabetes UK.

This is the first time the autoimmune condition of type 1 diabetes has been described in infants under six months old. Previously research suggested that babies in the first few months of life could only develop neonatal diabetes as a result of a genetic mutation.

The new study, published in Diabetologia, the journal of the European Association for the Study of Diabetes, suggests that the autoimmune condition which leads to the destruction of insulin-producing cells in the pancreas may begin in the womb, leading to the development of the condition in babies under six months old.

Scientists from the University of Exeter, King’s College London, and the Pacific Northwest Research Institute in Seattle, looked at the genes and insulin production levels in 166 children who had developed diabetes before six months, but did not have the genetic mutations known to cause neonatal diabetes. They compared these children with children who had confirmed neonatal diabetes, and a third group who were diagnosed with type 1 diabetes between 6 and 24 months.

Dr Matthew Johnston, from the Exeter Centre of Excellence in Diabetes 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.’

Children with very early-onset type 1 diabetes were found to have a lower than average birth weight. Usually, a foetus begins making insulin in the womb, helping them to grow. Immune system malfunction before birth could lead to reduced insulin production and consequently, low birth weight.

Dr Richard Oram, a research fellow at the University of Exeter, said: ‘The next phases of this work, where we study the immune system in more detail, will hopefully help explain how it is possible for type 1 diabetes to develop so early and whether these insights could open up new ways to prevent or treat the condition in the future.’

Neonatal and type 1 diabetes are treated differently; the correct diagnosis is essential for infants to receive the right treatment.