Environmental risk factors for type 1 diabetes in Rome and province

Abstract

Background: In subjects genetically susceptible to type 1 diabetes, exposure to environmental factors during the gestational period, the neonatal period, and the first years of life is thought to play an important role in triggering the immune process leading to β cell destruction. Aims: To investigate risk factors for inhabitants of continental Italy. Methods: A case-control study of 150 type 1 diabetes cases and 750 control subjects (age range 6-18 years) was carried out in Rome and its province, measuring the exposure to environmental risk factors. Results: Three environmental factors were found to occur significantly more in the diabetic group than in the controls. During the mothers' pregnancies, the one risk factor which proved to be higher in diabetics than in controls was maternal infectious disease. During the neonatal period, no risk factors associated with the disease were detected. During early life, eczema and a short duration of breast feeding (less than three months), occurred significantly more in diabetic cases than controls. Conclusion: Eczema and breast feeding for less than three months are risk factors for type 1 diabetes in a southern European population. The type, duration, and mode of treatment for infectious diseases during pregnancy need additional investigation as risk factors for type 1 diabetes.

Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies

“…Another study was excluded as it contained fewer than 15 cases [29]. A meeting abstract [31] was replaced with the subsequently published article [43] and, after contact with authors, an earlier report from a cohort [35] was replaced with a later report [18].…”

“…This observed increase in diabetes risk after Caesarean section delivery could not be explained by the confounding influence of birthweight, gestational age, maternal age, birth order, maternal diabetes or breastfeeding. Table 1 b Breast-feeding was categorised as breast-feeding at discharge from hospital [18,32], any breast-feeding [15,25,27], breast-feeding for approximately 3 months or more [30,40,43] and breast-feeding for approximately 4 months or more [37][38][39] Ref. cat., reference category…”

Birthweight and the risk of childhood-onset type 1 diabetes: a meta-analysis of observational studies using individual patient data

“…The findings of this research seem inconsistent, as some studies have concluded that high birthweight is associated with increased diabetes risk [8] or reduced diabetes risk [9], while others have shown no association with type 1 diabetes risk [10]. Interpretation of these findings is made more difficult because studies have reported associations using many different categorisations of birthweight [8,[11][12][13][14], with some [15,16] only reporting findings for the extremes of birthweight and others [17][18][19][20][21] not reporting their birthweight results in any detail, concentrating instead on other findings. This could lead to reporting bias if the decision to report birthweight findings was influenced by whether or not results were interesting or 'statistically significant'.…”

The Protein Tyrosine Phosphatase Nonreceptor 22 (PTPN22) Is Associated With High GAD Antibody Titer in Latent Autoimmune Diabetes in Adults

“…Adult-onset autoimmune diabetic subjects were selected using the following inclusion criteria: 1) an initial diagnosis of type 2 diabetes according to the American Diabetes Association (14), 2) documented antibody positivity for GADAs (15), 3) no insulin requirement and no evidence of ketosis from diagnosis to screening time, and 4) disease duration between 6 months and 5 years. Type 1 diabetic subjects (n ϭ 558) (age at onset 14.9 Ϯ 7.8 years) were recruited by participating centers of the Immunotherapy Diabetes (IMDIAB) group in the Lazio region of central Italy (16). The control group comprised normoglycemic subjects (n ϭ 545) with no family history of autoimmune disorders (aged 30 Ϯ 5 years), collected from the Blood Transfusion Service of Sapienza University of Rome.…”