Here at Diabetes Self-Management, we tend to focus — as our name implies — on how people who already have diabetes can best manage their condition. But now and then, we report on ways to prevent diabetes in the first place. These stories nearly always focus on Type 2 diabetes, which studies suggest might be delayed or prevented through diet, exercise, and certain drugs. Type 1 diabetes — the autoimmune variety that tends to begin in childhood or young adulthood — is widely viewed, by both medical professionals and the informed public, as unrelated to lifestyle. Since we don’t fully know why the immune system attacks the beta cells of the pancreas in people with Type 1 diabetes, the risk of acquiring it is often attributed simply to genetics and chance.
But the landscape of risks for autoimmune diabetes is more complicated than that, as a recent study published in the journal Diabetes Care indicates. According to a Reuters article, the study found — based on data from 56,296 Norwegian adults collected over 24 years — that adults who reached college were almost twice as likely as those who didn’t finish high school to develop latent autoimmune diabetes in adults (LADA), which is very similar to Type 1 diabetes. Only 122 adults in the study developed this form of diabetes, compared with over 1,500 who developed Type 2 diabetes in the same period. The study’s lead author noted that education did not actually cause the increased rate of LADA among adults who received higher education; rather, the higher risk came either from a lifestyle stemming from higher education or from a factor that made higher education more likely in the first place. The study did, however, adjust results to correct for differences based on obesity, smoking, exercise level, and family history of diabetes, among other factors.
Ultimately, however, it is a mystery why an association between education level and LADA exists. These results mirror those of studies in which children with a higher socioeconomic background exhibit a higher risk of developing Type 1 diabetes. One theory is that children from a higher socioeconomic background — and perhaps also those who go on to higher education — experience less exposure to microbes, which may somehow increase the likelihood of an immune system malfunction. Testing such a hypothesis, however, is difficult, and any number of unknown factors could be responsible for the changes in autoimmune diabetes risk seen at different education and socioeconomic levels.
What do you think — could education lead to a higher rate of autoimmune diabetes, possibly through increased stress or other lifestyle changes? Do you put stock in the idea that a too-clean upbringing could lead to an underdeveloped immune system? If so, have you done anything in response (vacuuming less, taking kids swimming in lakes)? How much should we worry about how our actions affect our diabetes risk — both Type 1 and Type 2? Leave a comment below!