THE RELATION OF EARLY NUTRITION, INFECTIONS AND SOCIOECONOMIC-FACTORSTO THE DEVELOPMENT OF CHILDHOOD DIABETES

The relationship of development of diabetes from birth up to 15 years of age to the type of feeding in infancy, childhood infections and vac cination was studied in 55 patients attending Endocrinology Clinics of the Ethio-Swedish Children's and Tikur Anbessa Hospitals over a perio d of two years (January 1990 to December 1991). Seventy-four unaffecte d siblings and 107 unrelated controls were interviewed for comparison. No significant difference was found in relation to type of feeding up to the ages of three, six and 12 months or older between patients and unaffected siblings. Histories of measles, chicken pox and whooping c ough were equally distributed between the two groups. However, introdu ction of bottle-feeding was significantly more frequent among unrelate d controls at three months of age (9/39 diabetics versus 41/83 control s) and six months of age (26/39 diabetics vs 72/83 controls) x2=6.6, ( p < 0.01) and x2 = 5.6 (p < 0.05) respectively. The odds ratios betwee n diabetics and unrelated controls for introduction of bottle-feeding at three months and six months of age were 0.32 (confidence intervals 0.14-0.74) and 0.31 (confidence intervals 0.13-0.77) respectively. The use of cow's milk and other formulas in bottle-feeding showed a signi ficant negative association with the development of diabetes x2 = 5.8 (p < 0.025), x2 = 3.8 (p < 0.05) respectively. A history of vaccinatio n against tuberculosis, measles, diphtheria, pertussis, tetanus (DPT) and polio was significantly more common among unrelated controls than diabetics, x2 from 4.6 to 11.4 (p < 0.05 to p < 0.001). There was no s ignificant difference in family history of diabetes in first degree re latives, parental education and level of income between diabetics and unrelated controls. These findings, particularly those which are at va riance with findings in Europeans, warrant more extensive studies for verification.