Association of incidence of type 1 diabetes with mortality from infectious disease and with antibiotic susceptibility at a country level

Abstract

To investigate the association between country incidence of type 1 diabetes and mortality from infectious disease and antibiotic susceptibility. An ecological study to explore the relationship at a country level of the reported incidence of type 1 diabetes (DiaMond) to infectious disease mortality (World Health Organisation) and to antibiotic susceptibility (Alexander Project). There were significant negative correlations between the incidence of type 1 diabetes and mortality for all infectious diseases studied. There were also significant positive correlations between the incidence of type 1 diabetes and antibiotic susceptibilities of Strep. pneumoniae, but not to those of Haem. influenzae. Since infectious disease mortality and antibiotic susceptibility are surrogate markers for bacterial exposure, our results provide support for a negative association between bacterial exposure in a community and its incidence of type 1 diabetes. The consistency of our results as well as the highly statistically significant results of most of the associations studied reinforces the validity of our findings.

Does the level of bacterial exposure in early life impact the risk of Type 1 diabetes?

“…We found consistent and highly statistically significant negative correlations between the country incidence of Type 1 diabetes and country mortality from respiratory infections, tuberculosis, diarrheal diseases and country total mortality including mortality from infectious and parasitic diseases and respiratory infections [13]. We believe that infectious disease mortality is a marker of a country's infective burden.…”

Innate inflammation in type 1 diabetes

“…The “hygiene hypothesis” postulates that decreasing infectious disease exposures and the subsequent paucity of innate immune stimulation in early life primes the adaptive immune system towards autoimmunity (27). It is supported, in part, by the inverse relationship between T1D incidence and infectious disease mortality rates between countries (28). The “fertile field hypothesis” posits that microbial infections induce an innate immunological state primed for expansion of auto-reactive T-cells given the right stimuli (29).…”

8th Annual Symposium on Self-Monitoring of Blood Glucose (SMBG): April 16–18, 2015, Republic of Malta

“…A recent study found significant negative correlations between the incidence of T1D and mortality for all infectious diseases studied. 38 There were also significant positive correlations between the incidence of T1D and antibiotic susceptibilities of Streptococcus pneumoniae (causing pneumococcal disease) but not to those of Haemophilus influenzae (causing many kinds of serious infections). Because infectious disease mortality and antibiotic susceptibility are surrogate markers for bacterial exposure, these results provide support for a negative association between bacterial exposure in a community and its incidence of T1D.…”