[Environmental factors in the development of type 1 diabetes -- a new insight].

According to the traditional model of pathogenesis of type 1 diabetes - it develops in genetically susceptible individuals in whom environmental factors trigger an autoimmune process of beta-cell destruction. Although susceptibility may be inherited, there is a growing body of evidence showing the role of environmental factors that might not only trigger but also perpetuate the chronic autoimmune process. These factors may exert their action long before the disease manifests itself clinically, which significantly hampers their identification. Three groups of environmental factors that were most widely studied include of viral infections, feeding patterns in infancy and toxic compounds (especially nitrites). Other factors possibly playing a role in modifying the development of the disease are vaccinations, psychological stress and climatological factors. The authors summarize the data supporting the role of environmental factors in the development of the disease and show a more recent model of type 1 diabetes pathogenesis. It may partly explain why the disease incidence increased has so much in the last three decades despite markedly improved hygiene and health care standards.