**5. Conclusions**

The first nested case-control study in MIDIA on intestinal virus as triggers for Type 1 Diabetes did not support the hypothesis that faecal shedding of enteroviral RNA is a major predictor of advanced islet autoimmunity. Neither was there any association between human parechovirus and islet autoimmunity. Although also the rodent parechovirus, Ljungan virus, has been proposed as a potential environmental factor for Type 1 Diabetes, the results from the MIDIA study indicate that Ljungan virus is rare in young children since it was not found neither in controls or cases. The two cohort studies performed in MIDIA do, however, show that both maternal weight and self reported lower respiratory tract infections predict risk of islet autoimmunity, and particularly in the youngest age group. The MIDIA study did not find any evidence supporting the notion that genetic risk information about newborns has a negative impact on the mental health of Norwegian Mothers. Recruitment to MIDIA was stopped based on the Norwegian Biotechnology Law. It is therefore needed to extend international collaboration to identify the environmental triggers of type 1 diabetes. With the estimated increase of children with 50% having Type 1 Diabetes in 2020, and that the increase will be highest among children younger than 5 years (increase in prevalence with 70%) it is really important to extend collaborative efforts.
