Abstract

The incidence of type 1 diabetes is increasing, particularly in young children. Multicenter studies across Europe have shown a 5.4% annual rise in type 1 diabetes in children under the age of 5 years (1), increasing the burden on health care resources worldwide. Better understanding of the causes of this increase is required for new therapies or lifestyle changes to reverse this trend. The study by Leete et al. (2) in this issue of Diabetes demonstrates striking differences in the cellular composition of islet inflammation causing type 1 diabetes between children diagnosed before the age of 6 years and those developing disease at an older age that may help define mechanisms underlying accelerated progression to diabetes. The distinguishing feature of islet inflammation in very young children is a high proportion of infiltrating B lymphocytes.