ArticleDiabetologia2020
Childhood type 1 diabetes: an environment-wide association study across England.
Article in Diabetologia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Radon exposure and potential health effects other than lung cancer: a systematic review and meta-analysis.Frontiers in public health · 2024Pooled it
- Is Population Density Associated with Non-Communicable Disease in Western Developed Countries? A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Identifying Modifiable Factors and Their Joint Effect on Amyotrophic Lateral Sclerosis: A Prospective Cohort Study in the UK Biobank.Brain and behavior · 2026Article
- Glycaemic Control by Sociodemographic Factors in Adults With Type 1 Diabetes in England: Trends From 2007-2008 to 2023-2024.Diabetes, obesity & metabolism · 2026Article
- Geospatial clustering of type 1 diabetes in Sweden: a cohort study based on all residential locations from birth to diagnosis.Diabetologia · 2026Article
- Mixtures of key components of the external exposome in association with MRI biomarkers of brain structure: Multi-Ethnic Study of Atherosclerosis.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Increasing Contribution of Adolescent Type 1 Diabetes Drives Incidence Rates in Poland: A 40-Year-Long Observational Study.Hormone research in paediatrics · 2026Observational
- Modifiable influencing factors and their joint effects on early- and late-onset coronary heart disease.Nature communications · 2025Article
- Article
- Identifying modifiable factors and their causal effects on osteoporosis risk.Scientific reports · 2025Article
- Identifying modifiable factors and their joint effect on frailty: a large population-based prospective cohort study.GeroScience · 2025Article
- Oxidative stress and pediatric diabetic cardiovascular complications: emerging research and clinical applications.American journal of physiology. Heart and circulatory physiology · 2025Review
- Exposomics: a review of methodologies, applications, and future directions in molecular medicine.EMBO molecular medicine · 2025Review
- Neuroimmune axis: Linking environmental factors to pancreatic β-cell dysfunction in Diabetes.Brain, behavior, & immunity - health · 2025Article
- A Scoping Review of GIS Mapping of Type 1 Diabetes in Children: Identifying Current Gaps and Future Research Directions Using PRISMA-ScR.Current diabetes reviews · 2025Article
- Identifying modifiable factors and their joint effect on dementia risk in the UK Biobank.Nature human behaviour · 2023Article
- Critical Overview on Endocrine Disruptors in Diabetes Mellitus.International journal of molecular sciences · 2023Review
- Air Pollution, Oxidative Stress, and the Risk of Development of Type 1 Diabetes.Antioxidants (Basel, Switzerland) · 2022Review
- Adult-onset autoimmune diabetes.Nature reviews. Disease primers · 2022Review
- Investigating the association of environmental exposures and all-cause mortality in the UK Biobank using sparse principal component analysis.Scientific reports · 2022Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
aims/hypothesisType 1 diabetes is an autoimmune disease affecting ~400,000 people across the UK. It is likely that environmental factors trigger the disease process in genetically susceptible individuals. We assessed the associations between a wide range of environmental factors and childhood type 1 diabetes incidence in England, using an agnostic, ecological environment-wide association study (EnWAS) approach, to generate hypotheses about environmental triggers.
methodsWe undertook analyses at the local authority district (LAD) level using a national hospital episode statistics-based incident type 1 diabetes dataset comprising 13,948 individuals with diabetes aged 0-9 years over the period April 2000 to March 2011. We compiled LAD level estimates for a range of potential demographic and environmental risk factors including meteorological, land use and environmental pollution variables. The associations between type 1 diabetes incidence and risk factors were assessed via Poisson regression, disease mapping and ecological regression.
resultsCase counts by LAD varied from 1 to 236 (median 33, interquartile range 24-46). Overall type 1 diabetes incidence was 21.2 (95% CI 20.9, 21.6) per 100,000 individuals. The EnWAS and disease mapping indicated that 15 out of 53 demographic and environmental risk factors were significantly associated with diabetes incidence, after adjusting for multiple testing. These included air pollutants (particulate matter, nitrogen dioxide, nitrogen oxides, carbon monoxide; all inversely associated), as well as lead in soil, radon, outdoor light at night, overcrowding, population density and ethnicity. Disease mapping revealed spatial heterogeneity in type 1 diabetes risk. The ecological regression found an association between type 1 diabetes and the living environment domain of the Index of Multiple Deprivation (RR 0.995; 95% credible interval [CrI] 0.991, 0.998) and radon potential class (RR 1.044; 95% CrI 1.015, 1.074). CONCLUSIONS/
interpretationOur analysis identifies a range of demographic and environmental factors associated with type 1 diabetes in children in England.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.