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Diabetes Metab Res Rev. 2008 Mar-Apr;24(3):211-22.

Early infant feeding and risk of type 1 diabetes mellitus-a nationwide population-based case-control study in pre-school children.

Author information

1
Institute of Biometrics and Epidemiology, German Diabetes Centre, Leibniz Institute at Heinrich-Heine University Düsseldorf, Germany. joachim.rosenbauer@ddz. uni-duesseldorf.de

Abstract

BACKGROUND:

The evidence on the role of environmental factors in the development of type 1 diabetes is conflicting. Reducing potential bias and the variety of exposures, we investigated the association between type 1 diabetes risk and nutritional and environmental exposures in pre-school children.

METHODS:

This nationwide population-based case-control study included 760 cases under 5 years of age newly diagnosed with type 1 diabetes during 1992-1995. From the general population, 1,871 controls were randomly selected and individually matched on age ( +/- 1 year), sex, and residence. Information on infant diet, foetal, perinatal and socio-economic factors, and familial diabetes was obtained by a parent-administered questionnaire. Data were analysed by multiple conditional logistic regression.

RESULTS:

Duration of breastfeeding and age at introduction of bottle-feeding were inversely associated with type 1 diabetes risk according to a dose-response relationship (trend test p < 0.05). Adjusted odd ratios (95% CI) for a long breastfeeding period and a late introduction of bottle-feeding (>or=5 month versus < 2 weeks) were 0.71 (0.54-0.93) and 0.80 (0.62-1.04), respectively. Familial type 1 diabetes, maternal age > 40 years, and low birth weight were found more frequently among diabetic than among control children. Current cow's milk consumption, higher social status, and a larger family were associated with a reduced diabetes risk. Up to one half of the diabetic cases in the population could be attributed to modifiable exposures.

CONCLUSIONS:

Our findings indicate that infant feeding is associated with type 1 diabetes risk and that a considerable part of new type 1 diabetic cases is potentially preventable.

PMID:
17968982
DOI:
10.1002/dmrr.791
[Indexed for MEDLINE]

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