Type 1 diabetes is an autoimmune disease in which the patient's immune system destroys the insulin-secreting beta-cells in the pancreatic islets of Langerhans. A majority of cases is thought to occur as a result of gene-environment interactions. The identity of the environmental factors remains unknown mainly because of the difficulty in linking past exposures with later disease development. Overall, the data suggest a model in which individuals develop diabetes by several different pathways, each influenced by numerous genetic and environmental variables. The most investigated environmental factors are diet and viruses. In this review, we examine the evidence that the source of dietary proteins can modify diabetes outcome, describe new approaches to identify candidate diabetes-related dietary agents, examine possible links with gut dysfunction, discuss some of the limitations, and propose a multifactorial model for dietary modification of diabetes. The key to diabetes pathogenesis, its prevention, and the ultimate success of beta-cell replacement therapies lies in understanding how the environment controls disease expression. Dietary proteins could be one of these keys.

中文翻译：

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膳食蛋白可作为1型糖尿病的环境调节剂。

1型糖尿病是一种自身免疫性疾病，其中患者的免疫系统破坏了Langerhans胰岛中分泌胰岛素的β细胞。人们认为大多数情况是由于基因-环境相互作用而发生的。环境因素的身份仍然未知，主要是因为难以将过去的暴露与以后的疾病发展联系起来。总体而言，数据提示了一个模型，其中个体通过几种不同的途径发展为糖尿病，每种途径均受众多遗传和环境变量的影响。研究最多的环境因素是饮食和病毒。在这篇评论中，我们研究了膳食蛋白质来源可以改变糖尿病预后的证据，描述了识别候选糖尿病相关饮食药物的新方法，检查与肠道功能障碍的可能联系，讨论一些局限性，并提出糖尿病饮食改变的多因素模型。糖尿病发病机制，其预防以及β细胞替代疗法最终成功的关键在于了解环境如何控制疾病的表达。膳食蛋白质可能是这些关键之一。