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This slow disease progression should be viewed in relation to the total \u03b2\u2010cell mass of only 0.2 to 1.5\u2009g in adults without diabetes. Focal lesions of acute pancreatitis with accumulation of leukocytes, often located around the ducts, are frequently observed in people with recent\u2010onset T1D, and most patients display extensive periductal fibrosis, the end stage of inflammation. An injurious inflammatory adverse event, occurring within the periductal area, may have negative implications for islet neogenesis, dependent on stem cells residing within or adjacent to the ductal epithelium. This could in part prevent the 30\u2010fold increase in \u03b2\u2010cell mass that would normally occur during the first 20\u2009years of life. This increase occurs in order to maintain glucose metabolism during the physiological increases in insulin production that are required to balance the 20\u2010fold increase in body weight during childhood and increased insulin resistance during puberty. Failure to expand \u03b2\u2010cell mass during childhood would lead to clinically overt T1D and could help to explain the apparently more aggressive form of T1D occurring in growing children when compared with that observed in affected adults.<\/jats:p>","DOI":"10.1111\/dom.13144","type":"journal-article","created":{"date-parts":[[2017,10,30]],"date-time":"2017-10-30T10:56:38Z","timestamp":1509360998000},"page":"775-785","source":"Crossref","is-referenced-by-count":11,"title":["Aetiology of type 1 diabetes: Physiological growth in children affects disease progression"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9713-722X","authenticated-orcid":false,"given":"Oskar","family":"Skog","sequence":"first","affiliation":[{"name":"Department of Immunology, Genetics and Pathology Uppsala University  Uppsala 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