Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Looking back at the TEDDY study : lessons and future directions

Lernmark, Åke LU orcid ; Agardh, Daniel LU ; Akolkar, Beena ; Gesualdo, Patricia ; Hagopian, William A ; Haller, Michael J ; Hyöty, Heikki ; Johnson, Suzanne Bennett LU ; Larsson, Helena Elding LU orcid and Liu, Edwin , et al. (2025) In Nature Reviews Endocrinology 21(3). p.154-165
Abstract

The goal of the TEDDY (The Environmental Determinants of Diabetes in the Young) study is to elucidate factors leading to the initiation of islet autoimmunity (first primary outcome) and those related to progression to type 1 diabetes mellitus (T1DM; second primary outcome). This Review outlines the key findings so far, particularly related to the first primary outcome. The background, history and organization of the study are discussed. Recruitment and follow-up (from age 4 months to 15 years) of 8,667 children showed high retention and compliance. End points of the presence of autoantibodies against insulin, GAD65, IA-2 and ZnT8 revealed the HLA-associated early appearance of insulin autoantibodies (1-3 years of age) and the later... (More)

The goal of the TEDDY (The Environmental Determinants of Diabetes in the Young) study is to elucidate factors leading to the initiation of islet autoimmunity (first primary outcome) and those related to progression to type 1 diabetes mellitus (T1DM; second primary outcome). This Review outlines the key findings so far, particularly related to the first primary outcome. The background, history and organization of the study are discussed. Recruitment and follow-up (from age 4 months to 15 years) of 8,667 children showed high retention and compliance. End points of the presence of autoantibodies against insulin, GAD65, IA-2 and ZnT8 revealed the HLA-associated early appearance of insulin autoantibodies (1-3 years of age) and the later appearance of GAD65 autoantibodies. Competing autoantibodies against tissue transglutaminase (marking coeliac disease autoimmunity) also appeared early (2-4 years). Genetic and environmental factors, including enterovirus infection and gastroenteritis, support mechanistic differences underlying one phenotype of autoimmunity against insulin and another against GAD65. Infant growth and both probiotics and high protein intake affect the two phenotypes differently, as do serious life events during pregnancy. As the end of the TEDDY sampling phase is approaching, major omics approaches are in progress to further dissect the mechanisms that might explain the two possible endotypes of T1DM.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Nature Reviews Endocrinology
volume
21
issue
3
pages
154 - 165
publisher
Nature Publishing Group
external identifiers
  • pmid:39496810
  • scopus:85208097101
ISSN
1759-5037
DOI
10.1038/s41574-024-01045-0
language
English
LU publication?
yes
additional info
© 2024. Springer Nature Limited.
id
5244c876-e411-4baf-af28-f16499ed8511
date added to LUP
2024-11-05 10:39:55
date last changed
2025-09-25 15:10:42
@article{5244c876-e411-4baf-af28-f16499ed8511,
  abstract     = {{<p>The goal of the TEDDY (The Environmental Determinants of Diabetes in the Young) study is to elucidate factors leading to the initiation of islet autoimmunity (first primary outcome) and those related to progression to type 1 diabetes mellitus (T1DM; second primary outcome). This Review outlines the key findings so far, particularly related to the first primary outcome. The background, history and organization of the study are discussed. Recruitment and follow-up (from age 4 months to 15 years) of 8,667 children showed high retention and compliance. End points of the presence of autoantibodies against insulin, GAD65, IA-2 and ZnT8 revealed the HLA-associated early appearance of insulin autoantibodies (1-3 years of age) and the later appearance of GAD65 autoantibodies. Competing autoantibodies against tissue transglutaminase (marking coeliac disease autoimmunity) also appeared early (2-4 years). Genetic and environmental factors, including enterovirus infection and gastroenteritis, support mechanistic differences underlying one phenotype of autoimmunity against insulin and another against GAD65. Infant growth and both probiotics and high protein intake affect the two phenotypes differently, as do serious life events during pregnancy. As the end of the TEDDY sampling phase is approaching, major omics approaches are in progress to further dissect the mechanisms that might explain the two possible endotypes of T1DM.</p>}},
  author       = {{Lernmark, Åke and Agardh, Daniel and Akolkar, Beena and Gesualdo, Patricia and Hagopian, William A and Haller, Michael J and Hyöty, Heikki and Johnson, Suzanne Bennett and Larsson, Helena Elding and Liu, Edwin and Lynch, Kristian F and McKinney, Eoin F and McIndoe, Richard and Melin, Jessica and Norris, Jill M and Rewers, Marian and Rich, Stephen S and Toppari, Jorma and Triplett, Eric and Vehik, Kendra and Virtanen, Suvi M and Ziegler, Anette-G and Schatz, Desmond A and Krischer, Jeffrey}},
  issn         = {{1759-5037}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{154--165}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Nature Reviews Endocrinology}},
  title        = {{Looking back at the TEDDY study : lessons and future directions}},
  url          = {{http://dx.doi.org/10.1038/s41574-024-01045-0}},
  doi          = {{10.1038/s41574-024-01045-0}},
  volume       = {{21}},
  year         = {{2025}},
}