The incidence of type 1 diabetes has much increased in the last fifty years, making it the second most common autoimmune disease among children. Different studies have shown that besides genetic factors environment and changed diet due to modern lifestyle also play an important role in the development of the disease. Diet can potentially influence the epigenetic regulations of the genome and the composition of the intestinal microbiota, which can affect the pathogenesis of diabetes. One of the possible mechanisms could be the crosstalk among the immune and nervous system and microbiota, mediated by microbial metabolites which also promote the expression of IL-22, one of the key cytokines for maintaining intestinal homeostasis and ensuring survival of beta cells in the pancreas. Lack of short-chain fatty acids due to dysbiosis and changes in the diet during the first months of a child’s life is crucial regarding microbial metabolites. There is an increasing amount of evidence that suggests that in addition to genetic predisposition environmental factors also help trigger autoimmunity against beta cells. New knowledge on environmental and metabolic markers can be used for predicting the onset and progression of type 1 diabetes as well as for developing new therapies that alter the ratio of the different genus of bacteria in the intestines and can reverse the epigenetic changes.
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