Rev Diabet Stud, 2017, 14(2-3):269-278 DOI 10.1900/RDS.2017.14.269

The Role of Iron in Type 1 Diabetes Etiology: A Systematic Review of New Evidence on a Long-Standing Mystery

Karen L. Søgaard1, Christina Ellervik2,3,4,5, Jannet Svensson1,3, Steffen U. Thorsen1

1Copenhagen Diabetes Research Center (CPH-DIRECT), Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730 Herlev, Denmark
2Department of Production, Research, and Innovation; Region Zealand, Alleen 15, 4180 Sorø, Denmark
3Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
4Department of Laboratory Medicine, Boston Children`s Hospital, 300 Longwood Avenue, 02115, Boston, MA, USA
5Harvard Medical School, 25 Shattuck St, 02115, Boston, MA, USA
Address correspondence to: Karen L. Søgaard, e-mail:

Manuscript submitted April 18, 2017; resubmitted July 13, 2017; accepted August 24, 2017.

Keywords: type 1 diabetes, iron overload, iron intake, risk factor, insulin, systematic review


BACKGROUND: The incidence of type 1 diabetes (T1D) is rising, which might be due to the influence of environmental factors. Biological and epidemiological evidence has shown that excess iron is associated with beta-cell damage and impaired insulin secretion. AIM: In this review, our aim was to assess the association between iron and the risk of T1D. METHODS: A systematic literature search was performed in PubMed and EMBASE in July 2016. Studies investigating the effect of iron status/intake on the risk of developing T1D later were included, and study quality was evaluated. The results have been summarized in narrative form. RESULTS: From a total of 931 studies screened, we included 4 observational studies evaluating iron intake from drinking water or food during early life and the risk of T1D. The quality of the studies was moderate to high assessed via the nine-star Newcastle Ottawa Scale. One out of the four studies included in this review found estimates of dietary iron intake to be associated with risk of T1D development, whereas three studies found no such relationship for estimates of iron in drinking water. CONCLUSIONS: The limited number of studies included found dietary iron, but not iron in drinking water, to be associated with risk of T1D. Further studies are needed to clarify the association between iron and risk of T1D, especially studies including measurements of body iron status.

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