What is the key environmental trigger in type 1 diabetes - Is it viruses, or wheat gluten, or both?

Prevention and treatment of type 1 diabetes is hampered by the fact that the key environmental trigger(s) of the disease is still unknown. Much of the data on this subject points to two possibilities, viruses and wheat gluten. Viruses appear to be involved as an etiological agent in some cases of type I diabetes, particularly in fulminant type 1 diabetes. Further analysis of the data suggests that viruses are not the sole trigger of type I diabetes in humans, and that wheat gluten may play a role in initiating the disease. Viruses may be the key environmental trigger in some cases of type 1 diabetes, and wheat gluten in others. Conceivably, some cases of type 1 diabetes might be caused by viruses and wheat gluten acting together as disease triggers. (c) 2012 Elsevier B.V. All rights reserved.