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 ß 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.
Full Text
The Full Text of this article is available as a PDF (101.6 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Akerblom H. K., Knip M. Putative environmental factors in Type 1 diabetes. Diabetes Metab Rev. 1998 Mar;14(1):31–67. doi: 10.1002/(sici)1099-0895(199803)14:1<31::aid-dmr201>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]
- Coughlin S. S. Recall bias in epidemiologic studies. J Clin Epidemiol. 1990;43(1):87–91. doi: 10.1016/0895-4356(90)90060-3. [DOI] [PubMed] [Google Scholar]
- Dahlquist G. Environmental risk factors in human type 1 diabetes--an epidemiological perspective. Diabetes Metab Rev. 1995 Apr;11(1):37–46. doi: 10.1002/dmr.5610110104. [DOI] [PubMed] [Google Scholar]
- Dahlquist G., Källén B. Maternal-child blood group incompatibility and other perinatal events increase the risk for early-onset type 1 (insulin-dependent) diabetes mellitus. Diabetologia. 1992 Jul;35(7):671–675. doi: 10.1007/BF00400261. [DOI] [PubMed] [Google Scholar]
- Gonçalves A. A., Dias O., Langone F., Reis L. C., Boschero A. C. Thiopental inhibits K+ permeability of rat and mouse pancreatic beta-cells. Eur J Pharmacol. 1986 Jun 5;125(1):119–125. doi: 10.1016/0014-2999(86)90090-7. [DOI] [PubMed] [Google Scholar]
- Hellman B. Calcium and pancreatic beta-cell function. I. Stimulatory effects of pentobarbital on insulin release. Biochim Biophys Acta. 1977 May 26;497(3):766–774. doi: 10.1016/0304-4165(77)90297-5. [DOI] [PubMed] [Google Scholar]
- Hildebrand R., Everding J. Quantitativ-morphologische Untersuchung über die Wirkung einer Narkose mit Thiobutabarbital-Natrium auf das endokrine und exokrine Pankreas der Albinoratte. Anaesthesist. 1977 Oct;26(10):571–574. [PubMed] [Google Scholar]
- Hyppönen E., Lärä E., Reunanen A., Järvelin M. R., Virtanen S. M. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet. 2001 Nov 3;358(9292):1500–1503. doi: 10.1016/S0140-6736(01)06580-1. [DOI] [PubMed] [Google Scholar]
- Ksiazyk J. Wspóczesne poglady na zapotrzebowanie na witamine D oraz wapń i fosfor ze szczególnym uwzglednieniem niemowlat karmionych sztuczie. Med Wieku Rozwoj. 2000 Oct-Dec;4(4):423–430. [PubMed] [Google Scholar]
- McKinney P. A., Parslow R., Gurney K., Law G., Bodansky H. J., Williams D. R. Antenatal risk factors for childhood diabetes mellitus; a case-control study of medical record data in Yorkshire, UK. Diabetologia. 1997 Aug;40(8):933–939. doi: 10.1007/s001250050770. [DOI] [PubMed] [Google Scholar]
- Meerwaldt R., Odink R. J., Landaeta R., Aarts F., Brunekreef B., Gerritsen J., Van Aalderen W. M. C., Hoekstra M. O. A lower prevalence of atopy symptoms in children with type 1 diabetes mellitus. Clin Exp Allergy. 2002 Feb;32(2):254–255. doi: 10.1046/j.1365-2222.2002.01311.x. [DOI] [PubMed] [Google Scholar]
- Ogilvy-Stuart A. L. Neonatal thyroid disorders. Arch Dis Child Fetal Neonatal Ed. 2002 Nov;87(3):F165–F171. doi: 10.1136/fn.87.3.F165. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Onkamo P., Vänänen S., Karvonen M., Tuomilehto J. Worldwide increase in incidence of Type I diabetes--the analysis of the data on published incidence trends. Diabetologia. 1999 Dec;42(12):1395–1403. doi: 10.1007/s001250051309. [DOI] [PubMed] [Google Scholar]
- Rami B., Schneider U., Imhof A., Waldhör T., Schober E. Risk factors for type I diabetes mellitus in children in Austria. Eur J Pediatr. 1999 May;158(5):362–366. doi: 10.1007/s004310051092. [DOI] [PubMed] [Google Scholar]
- Sebastiani L., Visalli N., Adorisio E., Suppa M. A., Buzzetti R., De Cicco A. L., Giovannini C., Comerci M. D., Negri M., Pozzilli P. A 5-year (1989-1993) prospective study of the incidence of IDDM in Rome and the Lazio region in the age-group 0-14 years. Diabetes Care. 1996 Jan;19(1):70–73. doi: 10.2337/diacare.19.1.70. [DOI] [PubMed] [Google Scholar]
- Stene L. C., Ulriksen J., Magnus P., Joner G. Use of cod liver oil during pregnancy associated with lower risk of Type I diabetes in the offspring. Diabetologia. 2000 Sep;43(9):1093–1098. doi: 10.1007/s001250051499. [DOI] [PubMed] [Google Scholar]
- Streit M., Braathen L. R. Contact dermatitis: clinics and pathology. Acta Odontol Scand. 2001 Oct;59(5):309–314. doi: 10.1080/000163501750541183. [DOI] [PubMed] [Google Scholar]
- Variation and trends in incidence of childhood diabetes in Europe. EURODIAB ACE Study Group. Lancet. 2000 Mar 11;355(9207):873–876. [PubMed] [Google Scholar]
