Journal
LANCET
Volume 387, Issue 10035, Pages 2340-2348Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/S0140-6736(16)30507-4
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Funding
- National Institutes of Health [DK32493]
- Juvenile Diabetes Research Foundation [17-2013-535]
- Swedish Child Diabetes Foundation (Barndiabetesfonden)
- JDF-Wallenberg [K98-99JD-12813-01A]
- Swedish Medical Research Council (MFR) [K99-72X-11242-05A]
- Research Council of Southeast Sweden
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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 beta cells can be broken by several environmental exposures that induce generation of hybrid peptides acting as neoautoantigens.
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