Unfolding the Mystery of Autoimmunity: The Environmental Determinants of Diabetes in the Young (TEDDY) Study
Authors: Marian Rewers, Daniel Agardh, Suzanne Bennett Johnson, Ezio Bonifacio, Helena Elding Larsson, Patricia Gesualdo, William Hagopian, Michael J. Haller, Heikki Hyöty, Randi Johnson, Richard McIndoe, Eoin McKinney, Jessica Melin, Åke Lernmark, Richard E. Lloyd, Kristian F. Lynch, Jill M. Norris, Stephen S. Rich, Roswith Roth, Desmond Schatz, Jorma Toppari, Eric Triplett, Kendra Vehik, Suvi M. Virtanen, Anette-G. Ziegler, Beena Akolkar, Jeffrey P. Krischer, Marian Rewers, Kimberly Bautista, Judith Baxter, Daniel Felipe-Morales, Brigitte I. Frohnert, Marisa Stahl, Patricia Gesualdo, Michelle Hoffman, Randi Johnson, Rachel Karban, Edwin Liu, Jill Norris, Holly O’Donnell, Andrea Steck, Kathleen Waugh, Jorma Toppari, Olli G. Simell, Annika Adamsson, Suvi Ahonen, Mari Åkerlund, Sirpa Anttila, Leena Hakola, Sanni Heikura, Heikki Hyöty, Jorma Ilonen, Saori Itoshima, Sanna Jokipuu, Taru Karjalainen, Leena Karlsson, Pieta Kemppainen, Jukka Kero, Marika Korpela, Jaakko J. Koskenniemi, Miia Kähönen, Mikael Knip, Minna-Liisa Koivikko, Katja Kokkonen, Merja Koskinen, Mirva Koreasalo, Kalle Kurppa, Salla Kuusela, Jarita Kytölä, Jutta Laiho, Tiina Latva-aho, Siiri Leisku, Laura Leppänen, Katri Lindfors, Maria Lönnrot, Elina Mäntymäki, Markus Mattila, Maija E. Miettinen, Teija Mykkänen, Tiina Niininen, Sari Niinistö, Noora Nurminen, Sami Oikarinen, Hanna-Leena Oinas, Paula Ollikainen, Zhian Othmani, Sirpa Pohjola, Jenna Rautanen, Mia Rein, Minna Romo, Juulia Rönkä, Nelli Rönkä, Noora Ruotsalainen, Satu Simell, Päivi Tossavainen, Mari Vähä-Mäkilä, Eeva Varjonen, Riitta Veijola, Irene Viinikangas, Suvi M. Virtanen, Richard McIndoe, Desmond Schatz, Diane Hopkins, Michael Haller, Melissa Gardiner, Ashok Sharma, Laura Jacobsen, Percy Gordon, Jennifer Hosford, Anette-G. Ziegler, Ezio Bonifacio, Cigdem Sanverdi, Anja Heublein, Sandra Hummel, Annette Knopff, Melanie Köger, Sibylle Koletzko, Claudia Ramminger, Roswith Roth, Jennifer Schmidt, Marlon Scholz, Joanna Stock, Katharina Warncke, Lorena Müller, Christiane Winkler, Åke Lernmark, Daniel Agardh, Carin Andrén Aronsson, Rasmus Bennet, Corrado Cilio, Susanne Dahlberg, Malin Goldman Tsubarah, Emelie Ericson-Hallström, Lina Fransson, Emina Halilovic, Susanne Hyberg, Berglind Jonsdottir, Naghmeh Karimi, Helena Elding Larsson, Markus Lundgren, Jessica Melin, Kobra Rahmati, Anita Ramelius, Falastin Salami, Anette Sjöberg, Evelyn Tekum Amboh, Carina Törn, Terese Wiktorsson, Eva Andersson, Marie Andersson Turpeinen, Rawya Antar, Maria Ask, Jenny Bremer, Sylvia Bianconi Svensson, Ulla-Marie Carlsson, Magdalena Delikat Kulinski, Annika Fors, Ulla Fält, Thomas Gard, Joanna Gerardsson, Monika Hansen, Anna Hansson, Carina Hansson, Gertie Hansson, Elin M. Hård af Segerstad, Hanna Jisser, Fredrik Johansen, Linda Jonsson, Silvija Jovic, Sigrid Lenrick Forss, Barbro Lernmark, Marielle Lindström, Maria Markan, Theodosia Massadakis, Marlena Maziarz, Zeliha Mestan, Maria Månsson Martinez, Caroline Nilsson, Emma Nilsson, Yohanna Nordh, Karin Ottosson, Sara Rang, Anna Rosenquist, Monika Sedig Järvirova, Sara Sibthorpe, Birgitta Sjöberg, Ulrika Swartling, Erika Trulsson, Ulrika Ulvenhag, Anne Wallin, Ingrid Wigheden, Åsa Wimar, Sofie Åberg, William A. Hagopian, Michael Killian, Claire Cowen Crouch, Jennifer Skidmore, Ben Kim, Cody McCall, Arlene Meyer, Jared Radtke, Shreya Roy, Dorothy Becker, Margaret Franciscus, MaryEllen Dalmagro-Elias Smith, Ashi Daftary, Mary Beth Klein, Chrystal Yates, Jeffrey P. Krischer, Rajesh Adusumali, Sarah Austin-Gonzalez, Maryouri Avendano, Sandra Baethke, Brant Burkhardt, Martha Butterworth, Nicholas Cadigan, Joanna Clasen, Kevin Counts, Laura Gandolfo, Jennifer Garmeson, Veena Gowda, Shu Liu, Xiang Liu, Kristian Lynch, Jamie Malloy, Lazarus Mramba, Cristina McCarthy, Hemang M. Parikh, Cassandra Remedios, Chris Shaffer, Susan Smith, Noah Sulman, Roy Tamura, Dena Tewey, Henri Thuma, Michael Toth, Ulla Uusitalo, Kendra Vehik, Ponni Vijayakandipan, Melissa Wroble, Jimin Yang, Kenneth Young, Michael Abbondondolo, Lori Ballard, Rasheedah Brown, David Cuthbertson, Stephen Dankyi, Christopher Eberhard, Steven Fiske, David Hadley, Kathleen Heyman, Belinda Hsiao, Christina Karges, Francisco Perez Laras, Hye-Seung Lee, Qian Li, Colleen Maguire, Wendy McLeod, Aubrie Merrell, Steven Meulemans, Jose Moreno, Ryan Quigley, Laura Smith, Liping Yu, Dongmei Miao, Kathleen Gillespie, Kyla Chandler, Olivia Pearce, Sarah Stollery, Elinor Balch, Hanah Batholomew, Zahra Hashmi, Elisabeth Aardal Eriksson, Ing-Marie Lundgren, Ewa Lönn Karlsson, Dzeneta Neszirevic Dernroth, Michael Kalnoski, Chao-Nan Ting, Iris Erlund, Terhi Vihervaara, Petra Arohonka, Inga Liukko, Linda Patrikainen, Outi Ruotsalainen, Tiina Keippila, Stephen S. Rich, Wei-Min Chen, Suna Onengut-Gumuscu, Emily Farber, Rebecca Roche Pickin, Jonathan Davis, Jordan Davis, Dan Gallo, Jessica Bonnie, Paul Campolieto, Randie R. Little, Kuanysh Kabytaev, Curt Rohlfing, William Hagopian, Jared Radtke, Henry Erlich, Steven J. Mack, Anna Lisa Fear, Oliver Fiehn, Bill Wikoff, Brian Defelice, Dmitry Grapov, Tobias Kind, Mine Palazoglu, Luis Valdiviez, Benjamin Wancewicz, Gert Wohlgemuth, Joyce Wong, Joseph F. Petrosino, Richard E. Lloyd, Nadim J. Ajami, Tulin Ayvaz, Tonya Bauch, Harshavardhan Doddapaneni, Richard Gibbs, Rachel Hirsch, Kristi L. Hoffman, Hanna Houston, Diane S. Hutchinson, Sara Javornik Cregeen, Elizabeth Laval, Lenka Kusic, Ginger Metcalf, Hannah Moreno, Donna Muzny, Jacqueline L. O’Brien, Katelyn Payne, Ashlie Renner, Lauren Riley, Matthew C. Ross, Daniel P. Smith, Anil Surathu, Auriole Tamegnon, Xiangjun Tian, Michael Tisza, Nguyen Truong, Li Wang, Matthew C. Wong, Eduardo Zavala, Clive H. Wasserfall, William E. Winter, David L. Pittman, Santica M. Marcovina, Andrew N. Hoofnagle, Thomas O. Metz, Bobbie-Jo Webb-Robertson, Ernesto S. Nakayasu, Lisa Bramer, Athena Schepmoes, Panshak Dakup, Jin-Xiong She, Richard McIndoe, Haitao Liu, John Nechtman, Yansheng Zhao, Na Jiang, Yanna Tian, Guangkuo Dong, Clive H. Wasserfall, William E. Winter, David L. Pittman, Chris Deigan, Ricky Schrock, Polina Malone, Sandra Ke, Niveen Mulholland, Beena Akolkar, Thomas Briese, Todd Brusko, Teresa Buckner, Suzanne Bennett Johnson, Eoin McKinney, Tomi Pastinen, Steffen Ullitz Thorsen, Eric Triplett
Journal: Diabetes Care (2025)

In 2025, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health celebrates 75 years of leadership in diabetes research. The NIDDK serves people of the U.S. affected by or at risk for many chronic diseases, including diabetes and other endocrine, metabolic, and digestive disorders, by funding innovative research to develop better treatment and prevention and a cure for these conditions. Autoimmunity that leads to type 1 diabetes or celiac disease or thyroid autoimmunity affects 1 in 20 children and adolescents in the U.S. While treatments are available, prevention of these common autoimmune diseases has been elusive due to poor understanding of the environmental causes and their interactions with common predisposing or protective genetic variants. In 2002, the NIDDK established The Environmental Determinants of Diabetes in the Young (TEDDY) consortium to advance understanding of the causes and the natural history of type 1 diabetes and other autoimmune diseases. The overarching goal of TEDDY is to inform novel approaches to primary prevention of autoimmunity. In this large international prospective birth cohort study, standardized information has been collected concerning candidate environmental exposures along with serial blood, stool, nasal swab, and other biosamples, with creation of a central repository of data and biologic samples for hypothesis-based research. This review summarizes TEDDY’s major contributions to our understanding of environmental triggers, drivers, and modifiers of autoimmunity, and gene-environment interactions, leading to type 1 diabetes.