Diabetes, diet and autonomic denervation

Area of Science:

• Endocrinology
• Neuroscience
• Pediatrics

Background:

• Current theories (hygiene, accelerator, thrifty phenotype) inadequately explain Type 1 Diabetes Mellitus (T1DM) epidemiology and natural history.
• Early-onset T1DM is more prevalent in Western countries, sharing epidemiological traits with other childhood diseases.

Purpose of the Study:

• To propose and explore the autonomic denervation hypothesis for the etiology of T1DM.
• To investigate the link between infant autonomic nerve injury and T1DM development.

Main Methods:

• Review of existing literature on T1DM etiology, epidemiology, and infant health.
• Analysis of the proposed autonomic denervation mechanism involving pancreatic nerves.

Main Results:

• Autonomic denervation of the pancreas, caused by physical strain during defecation in infancy, may lead to islet cell loss and reduced insulin production.
• Dietary factors like early introduction of cow's milk and solids correlate with bowel issues in Western infants, unlike exclusive breastfeeding in non-Western countries.
• This denervation can manifest as T1DM in infancy or later life.

Conclusions:

• The autonomic denervation view provides a novel framework for understanding T1DM's origins and epidemiological patterns.
• Infant autonomic nerve injury, potentially linked to defecation strain and diet, is a plausible contributor to T1DM.
• This hypothesis may also elucidate the origins of other Western diseases linked to autonomic nervous system dysfunction.