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Cleanliness and Increased Rate of Type 1 Diabetes

Jan 31, 2014

The highest rates of type 1 diabetes are found in Finland, a country known for its cleanliness…. 

It may be surprising to learn that Finland, known for its cleanliness and high life expectancies, has the highest rate of type 1 diabetes in the world. With 58 out of 100,000 children being diagnosed with the disease, Finland has nearly three times the incidence of the United States with 24 cases per 100,000.

One proposed explanation for these high rates of type 1 diabetes stem from the "hygiene hypothesis". The hygiene hypothesis suggests that there may be a correlation with exposure to bacteria and other microbes early in life and being able to build a strong immune system. In order to test this hypothesis researchers have looked into nearby Russian cities which used to be part of Finland. These Russian cities are not as wealthy as Finland, and are known to have lower levels of hygiene. Russian children also play outside more than Finnish children and have a broader exposure to animals. In these dirtier environments, the rate of type 1 diabetes is less than 10 per 100,000.

In order to identify if this hypothesis is correct, researchers are traveling to these different environments and collecting microbial samples directly from infants and children, as well as dust samplings from their homes. These samples are currently being analyzed at the Harvard/MIT Broad Institute as well as Boston’s Massachusetts General Hospital. Whatever the results, researchers note that while they would not recommend a reversion to less hygienic environments, this research may help identify if some sort of drug or probiotic would be required to help bolster a child’s immune system and avoid a diagnosis of type 1 diabetes.

Practice Pearls:
  • Finland has the highest rates of type 1 diabetes in the world, with 58 cases per 100,000 people.
  • Research suggests there may be a connection between less hygienic conditions in childhood and lower rates of type 1 diabetes.
  • Samples of Finnish and Russian children from cities with differing levels of cleanliness are being analyzed by researchers in the U.S. to see if there is a connection between environment and a type 1 diabetes diagnosis.

Environmental Determinants of Diabetes in the Young, or TEDDY Jan 2014