The incidence of male childhood Type 1 (insulin-dependent) diabetes mellitus is rising rapidly in The Netherlands

Drykoningen, C. E. M.; Mulder, A. L. M.; Vaandrager, G.J.; Re, LaPorte; Bruining, G. J.

doi:10.1007/bf00402545

Cited by 32 publications

(16 citation statements)

References 22 publications

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“…In the United States and Western Europe, the current incidence rate for type 1 diabetes is second only to that of bronchial asthma in terms of the severe chronic diseases of childhood. Several European countries such as the United Kingdom and Finland have experienced more than a doubling in incidence of 'classical' type 1 diabetes over the past three decades [14,15]. In contrast, Asian countries including Japan, Korea and China have a low incidence.…”

Section: Epidemiology Of Type 1 Diabetes In Japanmentioning

confidence: 99%

Type 1 diabetes in Japan

2006

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Section: Epidemiology Of Type 1 Diabetes In Japanmentioning

confidence: 99%

Type 1 diabetes in Japan

2006

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“…In The Netherlands, the incidence of type 1 diabetes mellitus has been increasing for several years (22,23). Of particular interest is that between 1990 and 1995 the incidence of type 1 diabetes in children 0-4 years of age has doubled (24).…”

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confidence: 99%

Does the risk of childhood diabetes mellitus require revision of the guideline values for nitrate in drinking water?

Maanen

Albering

Kok

et al. 2000

Environ Health Perspect

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In recent years, several studies have addressed a possible relationship benteen nitrate exposure and childhood type 1 insulin-dependent diabetes meilitus. The present ecologic study describes a possible relation between the incidence of type 1 diabetes and nitrate levels in drinking water in The Netherlands, and evaluates whether the World Health Organization and the European Commission stndard for nitrate in drinking water (50 mg/L) is adequate to prevent risk of this disease. During 1993During -1995 Even though experimental data raise serious concern about the formation of Nnitroso compounds and carcinogenic risk, the epidemiologic evidence for an association between the intake of nitrate and cancer is regarded to be insufficient. Therefore, the World Health Organization (WHO) guideline value for nitrate in drinking water (50 mg/L nitrate units as nitrate ion) was established solely to prevent methemoglobinemia (6). In the European Union, the maximum admissible nitrate level in drinking water was also set at 50 mg/L (A). In a recent review on the role of drinking water nitrate as a cause of infantile methemoglobinemia (7), it was concluded that the standard of 50 mg/L might be unnecessarily strict and that gastrointestinal infection and inflammation and the ensuing overproduction of nitric oxide may be the cause of infantile methemoglobinemia attributed to drinking water nitrate (8). In our view, however, rather than raising the standard of nitrate to levels > 50 mg/L, other adverse health effects of nitrate exposure should be taken into consideration. We suggest that the present drinking water guideline value for nitrate of 50 mg/L needs to be reconsidered for multiple reasons. Even though the guideline value is aimed at the protection of infants as the highest risk group against methemoglobinemia, cases of methemoglobinemia as a result of exposure to nitrate in drinking water < 50 mg/L have been reported (59. In a previous study (1), we observed increased hprt variant frequencies in lymphocyte DNA of subjects who used private well water with nitrate levels below the guideline value of 50 mg/L as drinking water. Also, formation of the carcinogenic N-nitrosodimethylamine was observed during uptake of nitrate at the acceptable daily intake level-corresponding with the standard of nitrate in drinking water-in combination with nitrosatable

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“…Autoimmune IDDM can occur either acutely in childhood, or gradually as latent autoimmune diabetes of adults [5]. Of note is the recent unexplained increase in IDDM incidence, in particular in European countries [6] and also globally [7].…”

mentioning

confidence: 99%